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J Wrist Surg 2023; 12(01): 032-039
DOI: 10.1055/s-0042-1749678
Scientific Article

Surgical and Patient-Centered Outcomes of Open versus Arthroscopic Ganglion Cyst Excision: A Systematic Review

DesRaj M. Clark 
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Sarah Y. Nelson
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Matthew O'Hara
2   University of California Riverside, School of Medicine, Riverside, California
,
Robert M. Putko
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Michael D. Bedrin
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Christopher M. Daniels
3   Department of Orthopedic Surgery, Keller Army Community Hospital, West Point, New York
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Funding None.
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Abstract

Introduction As the popularity of wrist arthroscopy grows, it continues to prove useful in the treatment of ganglion cysts. Previous studies comparing an arthroscopic technique to traditional open excision have demonstrated generally equivalent results regarding complications and cyst recurrence. However, this systematic review compares the two treatment methods not only regarding cyst recurrence but also regarding patient-centered outcomes. Additionally, new studies in the available literature may allow for further analysis.

Methods This systematic review identified 23 articles published between 2000 and 2021 that met inclusion criteria. Articles were assessed for quality, and reported cyst recurrence rates, patient satisfaction, patients' preoperative and postoperative pain, and complications associated with either open or arthroscopic excisions were pooled into open excision and arthroscopic excision groups for analysis.

Results In total, 23 studies accounted for 1,670 cases. Pooled data for patient-centered outcomes indicated a significantly higher patient satisfaction rate (89.2 vs 85.6%, p < 0.001) and higher reported pain relief (69.5 vs. 66.7%, p = 0.011) associated with arthroscopic excision versus open excision. Recurrence rates were also significantly lower for the arthroscopic excision group (9.4 vs. 11.2%, p < 0.001). Overall, the complication rate was significantly lower for arthroscopic excision (7.5 vs. 10.7%, p < 0.001), but the complication profile distinctly differed between the two methods.

Conclusions Both arthroscopic and open excision of dorsal wrist ganglions are viable treatment options. However, the results of this meta-analysis suggest benefits associated with the arthroscopic technique in both patient-centered outcomes and in traditional, surgical outcomes. This may prove advantageous as wrist arthroscopy becomes more common.

Keywords

arthroscopy - dorsal wrist ganglion - ganglion cyst - patient-centered outcomes

Ethical Approval

Institutional review board approval was not required for this study as it did not involve patient care or animal models. This is a literature review study.




Publication History

Received: 22 November 2021

Accepted: 20 April 2022

Article published online:
13 June 2022

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