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J Wrist Surg 2024; 13(05): 439-445
DOI: 10.1055/s-0043-1775999
Scientific Article

Recurrence, Reoperation, and Patient-Reported Outcomes after Wrist Ganglion Excision

Jonathan Lans 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Keith M. George
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Merel Hazewinkel
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Kyle R. Eberlin
2   Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School. Boston, Massachusetts
,
Neal C. Chen
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Rohit Garg
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Funding None.
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Abstract

Background Ganglion excision is performed for pain, functional impairment, or cosmetic reasons, with recurrence rates ranging between 9 and 20%. The aim of this study was to evaluate the recurrence and reoperation rates after ganglion excision, along with assessing patient-reported outcomes.

Methods Retrospectively, 1,076 patients, with 1,080 wrist ganglia, were identified who underwent open excision (n = 1,055) and arthroscopic excision (n = 25). The ganglia were predominantly dorsal (59%) and volar (37%). Additionally, 149 patients who underwent open excision and all who underwent arthroscopic excision were contacted to complete a questionnaire on recurrence and reoperation, the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and the Patient-Rated Wrist Evaluation (PRWE). Seventy-seven patients responded at a median of 4 years postoperatively. A matched case-control analysis was performed to identify factors associated with reoperation, along with a bivariate analysis to assess what factors influence patient-reported outcomes.

Results The reoperation rate was 3.3%, with no factors statistically associated with reoperation in case-control analysis. Among the contacted patients, 13% reported a recurrence, of which 2.6% reported reoperation. The median QuickDASH score was 2.3 (interquartile range [IQR]: 0–12), the median PRWE score was 0 (IQR: 0–12), and the median pain score was 0 (IQR: 0–3), with female sex being associated with higher scores.

Conclusion The reoperation rate after ganglion excision is low (3.3%) and is mostly performed within 3 years. The self-reported ganglion recurrence is higher (13%), but only one-fifth of these patients reported a repeat excision. After surgery, patients report good functional scores, with little persistent pain.

Keywords

wrist ganglion - ganglion excision - surgical outcomes

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.


Statement of Informed Consent

Informed consent was waived by the Institutional Review Board given the retrospective nature of this study, along with the large number of patients.


Supplementary Material



Publication History

Received: 29 May 2023

Accepted: 12 September 2023

Article published online:
09 October 2023

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