Audit of Clinical and Functional Outcomes of Arthroscopic Resection of Wrist Ganglions

Background: The purpose of this study is to audit the clinical and functional outcomes of arthroscopic ganglionectomy (AG) in our centre. Methods: A retrospective study was conducted on all 29 patients who underwent AG from 2007 to 2012 with a mean clinic and telephone follow-up duration of 6 months and 32 months respectively. Results: A total of 29 patients (17 women and 12 men) with a mean age of 38 years underwent AG. 15 patients (52%) had associated pain with the lump, 24 out of 29 patients (83%) had preoperative ultrasound to confirm the diagnosis. All patients had preoperative wrist radiographs that showed no chronic carpal instability and bony pathology. 26 out of 29 patients (90%) had dorsal wrist ganglions and 3 patients (10%) had volar wrist ganglions. 15 out of 24 ganglions (62.5%) were multiloculated. Mean ganglion size clinically and through wrist ultrasound was 2.5 cm and 1.8 cm respectively. During arthroscopy, ganglion stalk was identified in 14 patients (48%). Average operating time was 69.5 minutes. Intraoperatively, 24 out of 29 patients (83%) had wrist synovitis and 26 patients (90%) had associated carpal ligament laxity. 97% of cases were successfully resected arthroscopically. Recurrence rate was 10% (3 cases). There was no significant difference between preoperative and postoperative range of motion of wrists -the mean wrist flexion ranged from 63 to 59 degrees pre and postoperatively, and the mean wrist extension ranged from 66 to 64 degrees pre and postoperatively. Overall grip strength improved from 27 kg to 32 kg (p > 0.05), and there was also a significant improvement in pain scores pre and post-operatively from visual analogue scale (VAS) score of 0.8 to 0.3 (p = 0.018). No major intra or post-operative complications occurred. All patients were satisfied in terms of cosmesis. Conclusions: AG is a safe and reliable alternative to open resection of wrist ganglions. In addition, it can be used as a diagnostic and therapeutic tool for other wrist conditions.