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Comparing Open Versus Arthroscopic Surgery for Wrist Ganglion
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Posted on: 11/30/1999
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This is the first study to compare the results of open versus arthroscopic surgery for wrist ganglion. The authors compared the rates of ganglion recurrence between the two groups. They also looked at postoperative pain in both groups.
Two senior hand surgeons did all of the operations. Patients were randomly assigned to the open or arthroscopic group. Half the group had a minimal incision with the arthroscopic approach. The surgeon used an arthroscopic shaver to remove the ganglion and stalk down to the scapholunate ligament. The other half of the group had the ganglion removed using an open technique and skin incision. The ganglion was cut off at the base of the stalk.
Everyone was followed for at least one full year. The researchers compared a variety of factors. They looked at patient age and number of complications between the two groups. Pain, recurrence, gender (male or female), and workers' compensation status were compared.
The authors report that the surgical technique used in the treatment of wrist ganglions was equal between open and arthroscopic methods. One is not superior to the other in preventing ganglion recurrence.
A larger study size is needed to confirm these results. There were a fair number of patients in both groups who did not come back for follow-up. The rate of recurrence in these patients is unknown and could change the overall results.
Arthroscopic surgery for wrist ganglion has several possible advantages. It gives the surgeon a direct view of the wrist. The procedure is less invasive than open surgery. Patients may regain wrist and hand function sooner after arthroscopic removal of the ganglion. Rate of recurrence does not appear to be different between the two approaches.
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References:
Lana King, MD, et al. Arthroscopic Versus Open Dorsal Ganglion Excision: A Prospective, Randomized Comparison of Rates of Recurrence and of Residual Pain. In The Journal of Hand Surgery. April 2008. vol. 33A. No. 4. Pp. 471-475.
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