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Results of Ganglion Removal with Arthroscopy

There was a time when some doctors said the best treatment for a wrist ganglion was to smack the wrist with a heavy book. A more up-to-date treatment is surgery to remove the fluid-filled cyst. That operation has also progressed from an open procedure to arthroscopy.

In arthroscopy, the doctor inserts a long, slender tool into the area. The scope has a tiny TV camera on the end. It projects the view on a TV screen for the doctor to see what he or she is doing. The entire ganglion, its stalk (when visible), and part of the joint capsule are removed. Doctors are careful to avoid injuring the nearby tendons, ligaments, and nerves.

With any change or new way of doing something, doctors want to know how well it's working. In this study doctors at the Mayo Clinic report on the results of 41 patients who had a wrist ganglion taken out by arthroscopy. They found that motion and grip strength improved in all patients. One-fourth of the patients had stiffness at first. No one had an unstable wrist after the operation. Pain levels were also reduced. The ganglion came back in two patients and was removed with an open operation.

The authors conclude that arthroscopic removal of wrist ganglions is safe and reliable. The results of this study show that arthroscopy for ganglion removal is just as good as creating a large incision. Arthroscopy actually has some advantages over an open incision. The ganglion can be seen from all sides and taken out without damaging nearby soft tissues. The patient can start to move the wrist and hand early. The result is less stiffness and a faster return to normal.

References: Marco Rizzo, MD, et al. Arthroscopic Resection in the Management of Dorsal Wrist Ganglions: Results with a Minimum 2-Year Follow-Up Period. In The Journal of Hand Surgery. January 2004. Vol. 29A. No. 1. Pp. 59-62.

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