Arthroscopic excision of dorsal wrist ganglion: factors related to recurrence and postoperative residual pain.

PURPOSE: The purpose of this study was to assess the recurrence rate and postoperative residual pain rate after arthroscopic excision of dorsal wrist ganglia and the risk factors for recurrence and residual pain.

METHODS: A total of 115 wrists (111 patients: 57 men, 54 women; average age 34 years; range, 9 to 72 years) treated with arthroscopic excision for wrist dorsal ganglia between April 2005 and December 2009 were enrolled. The follow-up averaged 32 months (range, 12 to 67 months). Demographic data and operative details, including the presence of a ganglion stalk, were retrospectively reviewed and tested against recurrence and residual pain at final follow-up.

RESULTS: The recurrence rate of dorsal wrist ganglia after arthroscopic excision was 11% (13 of 115 wrists). Recurrence was on the dominant side in 12 of 13 (91%) patients, which was the most important risk factor for recurrence (odds ratio [OR], 8.0; 95% confidence interval [CI], 0.94 to 68.49), followed by female sex (OR, 4.9; 95% CI, 0.84 to 28.39) and age 24 years or younger (OR, 3.1; 95% CI, 0.75 to 12.74). Twenty-seven wrists (23%) had postoperative residual pain at final follow-up. The results of logistic regression showed that pain before surgery was the most important risk factor for residual pain after surgery (OR, 4.9; 95% CI, 1.36 to 18.3), followed by female sex (OR, 3.2; 95% CI, 1.22 to 8.53).

CONCLUSIONS: Dominant side, female sex, and age of 24 years or younger are considered to be the most influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia. However, the presence or absence of the cyst stalk was not a significant factor for recurrence. Female patients who have preoperative pain around the dorsal wrist ganglia were most likely to experience residual pain after surgery.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.