Purpose
The purpose of this study was to assess the recurrence rate and postoperative residual
pain rate after arthroscopic excision of dorsal wrist ganglia and the risk factors
for recurrence and residual pain.
Methods
A total of 115 wrists (111 patients: 57 men, 54 women; average age 34 years; range,
9 to 72 years) treated with arthroscopic excision for wrist dorsal ganglia between
April 2005 and December 2009 were enrolled. The follow-up averaged 32 months (range,
12 to 67 months). Demographic data and operative details, including the presence of
a ganglion stalk, were retrospectively reviewed and tested against recurrence and
residual pain at final follow-up.
Results
The recurrence rate of dorsal wrist ganglia after arthroscopic excision was 11% (13
of 115 wrists). Recurrence was on the dominant side in 12 of 13 (91%) patients, which
was the most important risk factor for recurrence (odds ratio [OR], 8.0; 95% confidence
interval [CI], 0.94 to 68.49), followed by female sex (OR, 4.9; 95% CI, 0.84 to 28.39)
and age 24 years or younger (OR, 3.1; 95% CI, 0.75 to 12.74). Twenty-seven wrists
(23%) had postoperative residual pain at final follow-up. The results of logistic
regression showed that pain before surgery was the most important risk factor for
residual pain after surgery (OR, 4.9; 95% CI, 1.36 to 18.3), followed by female sex
(OR, 3.2; 95% CI, 1.22 to 8.53).
Conclusions
Dominant side, female sex, and age of 24 years or younger are considered to be the
most influential risk factors for recurrence after arthroscopic excision of dorsal
wrist ganglia. However, the presence or absence of the cyst stalk was not a significant
factor for recurrence. Female patients who have preoperative pain around the dorsal
wrist ganglia were most likely to experience residual pain after surgery.
Level of Evidence
Level IV, therapeutic case series.
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References
- The dorsal ganglion of the wrist: Its pathogenesis, gross and microscopic anatomy, and surgical treatment.J Hand Surg. 1976; 1: 228-235
- Ganglion cysts of the wrist: Pathophysiology, clinical picture, and management.Curr Rev Musculoskelet Med. 2008; 1: 205-211
- Ganglions of the hand and wrist.J Am Acad Orthop Surg. 1999; 7: 231-238
- Current concepts in wrist arthroscopy.Arthroscopy. 2008; 24: 343-354
- Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years.Arthroscopy. 2010; 26: 1675-1682
- Arthroscopic resection of dorsal ganglion of the wrist.Hand Clin. 1995; 11: 7-12
- Arthroscopic resection in the management of dorsal wrist ganglions: Results with a minimum 2-year follow-up period.J Hand Surg. 2004; 29: 59-62
- Results and complications in dorsal and volar wrist ganglia arthroscopic resection.Hand Surg. 2006; 11: 21-26
- Arthroscopic versus open dorsal ganglion excision: A prospective, randomized comparison of rates of recurrence and of residual pain.J Hand Surg. 2008; 33: 471-475
- Pathogenesis, clinic, and treatment of ganglion.Arch Orthop Trauma Surg. 1982; 99: 247-252
- Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences.J Hand Surg Br. 2000; 25: 38-40
- Current treatment of ganglion of the wrist.Hand Surg. 2001; 6: 49-58
- Prospective outcomes and associations of wrist ganglion cysts resected arthroscopically.J Hand Surg. 2009; 34: 395-400
- Arthroscopic resection of the dorsal ganglia of the wrist.Hand Clin. 1999; 15: 429-434
- The treatment of dorsal wrist ganglia by radical excision.J Hand Surg Br. 1988; 13: 187-191
- Arthroscopic resection of wrist ganglia.Hand Surg. 2004; 9: 159-164
- Arthroscopic diagnosis and treatment of dorsal wrist ganglion.J Hand Surg Br. 2001; 26: 547-549
- Dorsal ganglion of the wrist: Results of treatment by arthroscopic resection.Hand Surg. 2002; 7: 1-5
- Arthroscopic treatment of dorsal ganglion cyst at the wrist. About 54 cases.Chir Main. 2006; 25 ([Article in French]): 146-151
- Arthroscopic ganglionectomy through an intrafocal cystic portal for wrist ganglia.Arthroscopy. 2010; 26: 617-622
- Methylene blue-enhanced arthroscopic resection of dorsal wrist ganglions.Tech Hand Up Extrem Surg. 2011; 15: 243-246
- Color-aided visualization of dorsal wrist ganglion stalks aids in complete arthroscopic excision.Arthroscopy. 2011; 27: 425-429
- The natural history of untreated dorsal wrist ganglia and patient reported outcome 6 years after intervention.J Hand Surg Eur Vol. 2007; 32: 502-508
- Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors.Knee Surg Sports Traumatol Arthrosc. 2009; 17: 705-729
- Risk factors for leg injuries in female soccer players: A prospective investigation during one out-door season.Knee Surg Sports Traumatol Arthrosc. 2001; 9: 313-321
- The ligaments of the wrist.J Hand Surg. 1976; 1: 110-118
Article info
Publication history
Accepted:
April 3,
2013
Received:
June 28,
2012
Footnotes
Supported by the research fund of Dankook University, Cheonan, Korea. The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
