Arthroscopic excision of wrist ganglions: does trans-cystic or cystic-sparing portal technique affect clinical outcomes?

Abstract

The preliminary results of arthroscopic wrist ganglionectomy were contradictory. The approach used for the arthroscopic excision of wrist ganglions may play an important role. We analyzed two surgical approaches for arthroscopic excision of wrist ganglions. Between April 2009 and October 2014, 49 patients with wrist ganglions who underwent arthroscopic excision in our institute were retrospectively classified into two treatment groups, namely the trans-cystic portal technique (TCP) and cyst-sparing portal technique (CSP). The visual analog scale (VAS), Mayo wrist scores, and disabilities of the arm, shoulder, and hand (DASH) scores were measured for clinical assessment. Recurrence, residual pain, and complications were evaluated at follow-up. No significant differences were found between the groups in terms of demographic data, and preoperative clinical assessment, as well as with regard to postoperative VAS score (p = 0.898), Mayo wrist score (p = 0.526), DASH score (p = 0.870), recurrence (p = 0.491), residual pain (p = 0.690), and complications (p = 0.352). Recurrence was found in 2 of the 47 patients and they were both in the CSP group. At the final follow-up, residual pain was found in four patients in the TCP group and three in the CSP group. For performing arthroscopic resection of wrist ganglions, both techniques are safe regarding the complication rates. In recurrence rate, no significant difference was found between the two groups, but no recurrence was observed when the TCP technique was used.