Arthroscopic excision of a painful wrist ganglion cyst

April 25th, 2007

A ganglion cyst is the most common type of benign soft tissue mass in the hand. These typically occur on the top side of the wrist, and may cause wrist pain, particularly when the wrist is extended.

Though cyst contents can be aspirated, recurrence occurs around 60-70% of the time because the cyst itself is not removed. In that light, definitive removal has relied on an open incision so that the cyst and its stalk can be removed. Recurrence rates are 2-3%.

Over the past several years, wrist arthroscopic techniques have developed to allow arthroscopic resection of dorsal wrist ganglion cysts. The recurrence rate is comparable to what is reported after open excision, but the incisions are only millimeters long. This results in earlier restoration of motion and pain relief, and no scars to speak of.

In the past 5 years, I have performed more than 25 arthroscopic ganglionectomies, and only one has recurred. Patient satisfaction has been very high. If you have a painful dorsal wrist ganglion, I would generally recommend that you consider an arthroscopic excision.

Related Photos:

Dorsal wrist ganglion before arthroscopic removal

Ganglion is encircled just prior to arthroscopic procedure

The stalk of the ganglion is visualized inside the joint

The ganglion has been removed and the incisions are sutured

Related Videos:

Needle placed from outside-in localizes cyst within the joint prior to resection

Ganglion is shaved away