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Arthroscopic ganglionectomy of the foot and ankle

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To study the efficacy of arthroscopic ganglionectomy in the management of ganglia of the foot and ankle.

Methods

From 2006 to 2010, arthroscopic ganglionectomy was performed for 89 ganglia in the foot and ankle of 88 patients. Clinical and intra-operative details were reviewed retrospectively.

Result

Ganglion stalk was identified in 6 % of the cases. The overall rate of presence of pathology was 26 %. The overall rate of recurrence or residual lesion was 12 % with high recurrent rate for extensor tendon ganglia and toe pulp ganglia.

Conclusions

Arthroscopic ganglionectomy of the foot and ankle ganglion by either internal drainage or complete resection is a feasible approach. Good results can be achieved in case of adequate internal drainage of the ganglion to the joints or fibrous tendon sheath.

Level of evidence

Therapeutic, Level IV.

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References

  1. Ahn JH, Choy WS, Kim HY (2010) Operative treatment for ganglion cysts of the foot and ankle. J Foot Ankle Surg 49:442–445

    Article  PubMed  Google Scholar 

  2. Antoniadis G, Scheglmann K (2008) Posterior tarsal tunnel syndrome: diagnosis and treatment. Dtsch Arztebl Int 105:776–781

    PubMed Central  PubMed  Google Scholar 

  3. Casal D, Bilhim T, Pais D, Almeida MA, O’Neill JG (2010) Paresthesia and hypesthesia in the dorsum of the foot as the presenting complaints of a ganglion cyst of the foot. Clin Anat 23:606–610

    Article  PubMed  Google Scholar 

  4. Edwards SG, Johansen JA (2009) Prospective outcomes and associations of wrist ganglion cysts resected arthroscopically. J Hand Surg 34A:395–400

    Article  Google Scholar 

  5. Friedli A, Saurat JH, Harms M (2002) Serpiginous ganglion cyst of the foot mimicking cutaneous larva migrans. J Am Acad Dermatol 47:S266–S267

    Article  PubMed  Google Scholar 

  6. Gallego S, Mathoulin C (2010) Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy 26:1675–1682

    Article  PubMed  Google Scholar 

  7. Green MR, Yanklowitz B (1992) Asymptomatic naviculocuneiform synostosis with a ganglion cyst. J Foot Surg 31:272–275

    CAS  PubMed  Google Scholar 

  8. Haslam ET (1952) Posterior ganglion at the ankle: a case report. Am Surg 18:191–194

    CAS  PubMed  Google Scholar 

  9. Ho PC, Lo WN, Hung LK (2003) Arthroscopic resection of volar ganglion of the wrist: a new technique. Arthroscopy 19:218–221

    Article  PubMed  Google Scholar 

  10. Huang JI, Gilmore A (2007) Ganglion cysts of the midfoot presenting as bilateral accessory tarsal navicular bones in a child: a case report. Foot Ankle Int 28(5):621–623

    Article  PubMed  Google Scholar 

  11. Kenjiro Nakama K, Gotoh M, Mitsui Y, Shirachi I, Higuchi F, Nagata K (2010) Use of autologous fibrin sealants to treat ganglion cysts: a report of two cases. J Orthop Surg 18:104–106

    Google Scholar 

  12. Kiehn MW, Gutowski KA (2004) A recurrent foot ganglion managed with extensor digitorum brevis muscle flap coverage. J Foot Ankle Surg 43:423–425

    Article  PubMed  Google Scholar 

  13. Kliman ME, Freiberg A (1982) Ganglia of the foot and ankle. Foot Ankle 3:45–46

    Article  CAS  PubMed  Google Scholar 

  14. Lui TH (2007) Arthroscopy and endoscopy of the foot and ankle: indications for new techniques. Arthroscopy 23:889–902

    Article  PubMed  Google Scholar 

  15. Lui TH (2011) Extensor tendoscopy of the ankle. Foot Ankle Surg 17:e1–e6

    Article  CAS  PubMed  Google Scholar 

  16. Lui TH (2009) Flexor hallucis longus tendoscopy: a technical note. Knee Surg Sports Traumatol Arthrosc 17:107–110

    Article  CAS  PubMed  Google Scholar 

  17. Lui TH (2006) New technique of arthroscopic triple arthrodesis. Arthroscopy 22:464.e1–464.e5

    Google Scholar 

  18. Lui TH (2007) Arthroscopic tarsometatarsal (Lisfranc) arthrodesis. Knee Surg Sports Traumatol Arthrosc 15:671–675

    Article  PubMed  Google Scholar 

  19. Lui TH, Chan KB, Ng S (2005) Arthroscopic lapidus arthrodesis. Arthroscopy 21:1516.e1–1516.e4

    Google Scholar 

  20. Lui TH (2008) Clinical tips: anterior subtalar (talocalcaneonavicular) arthroscopy. Foot Ankle Int 29:94–96

    Article  CAS  PubMed  Google Scholar 

  21. MacDonald DJM, Holt G, Vass K, Marsh A, Kumar CS (2007) The differential diagnosis of foot lumps: 101 cases treated surgically in North Glasgow over 4 years. Ann R Coll Surg Engl 89:272–275

    Article  PubMed Central  PubMed  Google Scholar 

  22. Nishikawa S, Toh S (2004) Arthroscopic treatment of a ganglion of the first metatarsophalangeal joint. Arthroscopy 20:69–72

    Article  PubMed  Google Scholar 

  23. Ogose A, Hotta T, Kawashima H, Endo N (2007) A painful large ganglion cyst of the ankle treated by the injection of OK-432. Mod Rheumatol 17:341–343

    Article  PubMed  Google Scholar 

  24. Osterman AL, Raphael JS (1995) Arthroscopic resection of dorsal ganglion of the wrist. Hand Clin 11:7–12

    CAS  PubMed  Google Scholar 

  25. Pontious J, Good J, Maxian SH (1999) Ganglions of the foot and ankle. A retrospective analysis of 63 procedures. J Am Podiatr Med Assoc 89:163–168

    Article  CAS  PubMed  Google Scholar 

  26. Rawool NM, Nazarian LN (2000) Ultrasound of the foot and ankle. Semin Ultrasound CT MRI 21:275–284

    Article  CAS  Google Scholar 

  27. Rodriguez NN, Blitz NM (2008) Hemorrhagic ganglion of the tibialis anterior tendon: report of an unusual variant. J Foot Ankle Surg 47:571–575

    Article  PubMed  Google Scholar 

  28. Rozbruch SR, Chang V, Bohne WH, Deland JT (1998) Ganglion cysts of the lower extremity: an analysis of 54 cases and review of the literature. Orthopedics 21:141–148

    CAS  PubMed  Google Scholar 

  29. Saeva JT, Kaye MR (1995) Presentation of an intermetatarsal ganglion. J Am Podiatr Med Assoc 85:274–276

    Article  CAS  PubMed  Google Scholar 

  30. Slavitt JA, Beheshti F, Lenet M, Sherman M (1980) Ganglions of the foot: a six-year retrospective study and a review of the literature. J Am Podiatr Assoc 70:459–465

    Article  CAS  Google Scholar 

  31. Talawadekar GD, Damodaran P, Jain SA (2010): Hourglass ganglion cyst of the foot: a case report. J Foot Ankle Surg 49:489.e11–489.e12

    Google Scholar 

  32. Tanaka Y, Takakura Y, Kumai T, Sugimoto K, Taniguchi A, Hattori K (2009) Sclerotherapy for intractable ganglion cyst of the hallux. Foot Ankle Int 30:128–132

    Article  PubMed  Google Scholar 

  33. van Dijk C, Kort N (1998) Tendoscopy of the peroneal tendons. Arthroscopy 14:471–478

    Article  PubMed  Google Scholar 

  34. van Dijk CN, Scholten PE, Krips R (2000) A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 16:871–876

    Article  PubMed  Google Scholar 

  35. Warren RF (1980) Ganglion of the sunus tarsi. A case report. Am J Sports Med 8:133–134

    Article  CAS  PubMed  Google Scholar 

  36. Yao J, Trindade MCD (2011) Color-aided visualization of dorsal wrist ganglion stalks aids in complete arthroscopic excision. Arthroscopy 27:425–429

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China

    T. H. Lui

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  1. T. H. Lui
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Corresponding author

Correspondence to T. H. Lui.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1: The extensor tendon ganglion moved with the toe motion. Supplementary material 1 (AVI 23752 kb)

Video 2: A case of extensor tendon ganglion at the ankle level. Apparently positive emptying sign was observed as the fluid was squeezed to the other side of the dumbbell lump. Supplementary material 2 (AVI 28687 kb)

Video 3: A case of sinus tarsi ganglion which present as a lump at anterior ankle. The lump can be emptied and refilled with compression at the sinus tarsi. Supplementary material 3 (AVI 26889 kb)

Video 4: A case of nodular type mutliloculation of syndesmosis ganglion. Supplementary material 4 (AVI 20471 kb)

Video 5: A case of first metatarsophalangeal ganglion. The gelatinous fluid of the cyst was aspirated. Normal saline was injected into the joint and the cyst refilled. Supplementary material 5 (AVI 7682 kb)

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Lui, T.H. Arthroscopic ganglionectomy of the foot and ankle. Knee Surg Sports Traumatol Arthrosc 22, 1693–1700 (2014). https://doi.org/10.1007/s00167-012-2065-8

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  • DOI: https://doi.org/10.1007/s00167-012-2065-8

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