The authors reviewed 37 patients with dorsal wrist ganglia who underwent arthroscopic cyst resection. The 1-2 and 4-5 portals were used as standard access intervals to the radiocarpal joint. Cysts were classified into three groups: Type 1- ganglia were visualized; Type 11a – ganglia were visualized by applying external compression; Type 11b – ganglia were not visualized. Type 1 and 11a ganglia were treated by limited arthroscopic resection of the ganglion and stalk. Type 11b ganglia were treated by removing a 1 cm diameter area of dorsal wrist capsule around the projected site of the cyst. Two ganglia recurred but there were no other reported complications at an average follow-up interval of 20 months.
Arthroscopic resection of a dorsal ganglion cyst is a reasonable alternative to open resection. Previous studies have reported low rates of cyst recurrence using this technique (Osterman et. al, Hand Clin 11: 7-12, 1995; Luchetti et. al, JHS 25B: 38-40, 2000). A concomitant arthroscopic evaluation of the wrist joint may be helpful in assessing other potential causes of wrist pain in difficult cases. A steep learning curve is expected, however, and the procedure may be difficult to perform if the cyst and stalk(s) are not localized to the scapholunate interval. The possibility of converting to an open technique should be discussed with the patient preoperatively.
Journal of Hand Surgery