Coexisting Intraarticular Disorders Are Unrelated To Outcomes After Arthroscopic Resection of Dorsal Wrist Ganglions
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Dorsal wrist ganglions are one of the most frequently encountered problems of the wrist and often are associated with intraarticular disorders. However, it is unclear whether coexisting intraarticular disorders influence persistent pain or recurrence after arthroscopic resection of dorsal wrist ganglions.
We investigated (1) which intraarticular disorders coexist with dorsal wrist ganglions and (2) whether they influenced pain, function, and recurrence after arthroscopic ganglion resection.
We retrospectively reviewed 41 patients with primary dorsal wrist ganglions who underwent arthroscopic resection. We also obtained VAS pain scores and the Mayo Wrist Scores (MWS) preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and annually thereafter postoperatively. Minimum followup was 24 months (mean, 38.9 months; range, 24–60 months).
Twenty-one patients had other coexisting intraarticular disorders: 18 triangular fibrocartilage complex tears and nine intrinsic ligament tears. All coexisting disorders were treated simultaneously. Two years after surgery, the mean VAS pain score decreased from 2.4 to 0.6, and mean grip strength increased from 28 to 36 kg of force. The mean active flexion-extension showed no change. The mean MWS improved from 74 to 91. Three ganglions recurred. There was no difference in mean VAS pain score and MWS preoperatively and at 2 years after surgery or recurrence of ganglions between patients with or without coexisting lesions.
Intraarticular disorders commonly coexist with ganglions but we found they were unrelated to pain, function, and recurrence after arthroscopic resection of the ganglion when the intraarticular disorders were treated simultaneously.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
- Angelides AC, Wallace PF. The dorsal ganglion of the wrist: its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg Am. 1976;1:228–235.
- Bienz T, Raphael JS. Arthroscopic resection of the dorsal ganglia of the wrist. Hand Clin. 1999;15:429–434.
- Chen AC, Lee WC, Hsu KY, Chan YS, Yuan LJ, Chang CH. Arthroscopic ganglionectomy through an intrafocal cystic portal for wrist ganglia. Arthroscopy. 2010;26:617–622. CrossRef
- Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radical excision. J Hand Surg Br. 1988;13:187–191.
- Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures: perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res. 1987;214:136–147.
- De Smet L. Ulnar variance: facts and fiction review article. Acta Orthop Belg. 1994;60:1–9.
- Edwards SG, Johansen JA. Prospective outcomes and associations of wrist ganglion cysts resected arthroscopically. J Hand Surg Am. 2009;34:395–400. CrossRef
- Gallego S, Mathoulin C. Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy. 2010;26:1675–1682. CrossRef
- Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL. Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am. 1996;78:357–365.
- Ho PC, Griffiths J, Lo WN, Yen CH, Hung LK. Current treatment of ganglion of the wrist. Hand Surg. 2001;6:49–58. CrossRef
- Kang L, Akelman E, Weiss AP. Arthroscopic versus open dorsal ganglion excision: a prospective, randomized comparison of rates of recurrence and of residual pain. J Hand Surg Am. 2008;33:471–475. CrossRef
- Luchetti R, Badia A, Alfarano M, Orbay J, Indriago I, Mustapha B. Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences. J Hand Surg Br. 2000;25:38–40. CrossRef
- McEvedy BV. The simple ganglion: a review of modes of treatment and an explanation of the frequent failures of surgery. Lancet. 1954;266:135–136. CrossRef
- Nakamura R, Tanaka Y, Umaeda T, Miura T. The influence of age and sex on ulnar variance. J Hand Surg Br. 1991;16:84–88. CrossRef
- Nishikawa S, Toh S, Miura H, Arai K, Irie T. Arthroscopic diagnosis and treatment of dorsal wrist ganglion. J Hand Surg Br. 2001;26:547–549. CrossRef
- Osterman AL, Raphael J. Arthroscopic resection of dorsal ganglion of the wrist. Hand Clin. 1995;11:7–12.
- 17. Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am. 1989;14:594–606. CrossRef
- Richman JA, Gelberman RH, Engber WD, Salamon PB, Bean DJ. Ganglions of the wrist and digits: results of treatment by aspiration and cyst wall puncture. J Hand Surg Am. 1987;12:1041–1043.
- Rizzo M, Berger RA, Steinmann SP, Bishop AT. Arthroscopic resection in the management of dorsal wrist ganglions: results with a minimum 2-year follow-up period. J Hand Surg Am. 2004;29:59–62. CrossRef
- Stephen AB, Lyons AR, Davis TR. A prospective study of two conservative treatments for ganglia of the wrist. J Hand Surg Br. 1999;24:104–105. CrossRef
- Watson HK, Rogers WD, Ashmead DT 4th. Reevaluation of the cause of the wrist ganglion. J Hand Surg Am. 1989;14:812–817. CrossRef
- Zachariae L, Vibe-Hansen H. Ganglia: recurrence rate elucidated by a follow-up of 347 operated cases. Acta Chir Scand. 1973;139:625–628.
- Zubowicz VN, Ishii CH. Management of ganglion cysts of the hand by simple aspiration. J Hand Surg Am. 1987;12:618–620.
- Coexisting Intraarticular Disorders Are Unrelated To Outcomes After Arthroscopic Resection of Dorsal Wrist Ganglions
Clinical Orthopaedics and Related Research®
Volume 471, Issue 7 , pp 2212-2218
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors