Similar recurrence rates seen with arthroscopic, open dorsal ganglion excision

LAS VEGAS — Although surgeons have cited many theoretical advantages of arthroscopic ganglionectomy compared to open ganglionectomy, recent research shows comparable rates of recurrence between the techniques.

In a recent prospective, randomized trial, orthopedic hand surgeon Arnold-Peter C. Weiss, MD, of Brown University and Rhode Island Hospital, and his colleagues studied 73 patients who had either open or arthroscopic resection for a dorsal ganglion cyst. Patients in both groups underwent the same postoperative treatment, Weiss said during his presentation at the American Society for Surgery of the Hand and American Association for Hand Surgery Specialty Day Meeting, here.

A minimum 12-months follow-up revealed an 8% recurrence rate for the open treatment group and a 10% rate in the arthroscopic group. Weiss also noted that the groups showed similar operative times and demonstrated no difference in range of motion by 2 months follow-up.

“My impression when we started this was that the arthroscopic approach would win by a lot, but my impression now is that you should really just do what you feel comfortable with. Or, if you are in a training program like I am, you have got to try to teach [students] both ways,” Weiss said.

“Recurrence is probably the same despite the technique and our biases. The reports on recurrence are anywhere from 0 to 30%, but probably you should tell patients between 5% and 10%."

He added: “Regardless of technique, the pain can last from 2 to 3 weeks, even in the arthroscopic group. A lot of times surgery can result in no pain, but sometimes there will be, and patients do like the lack of incision [with arthroscopy], especially young women who have cysts.”

Reference:
Weiss A-PC. Arthroscopic ganglionectomy. Presented at the American Society for Surgery of the Hand and American Association for Hand Surgery Specialty Day Meeting. Feb. 28, 2009. Las Vegas.