A Prospective Study of Two Conservative Treatments for Ganglia of the Wrist

Abstract

This randomized prospective study assessed whether multiple puncture of the ganglion wall improves the results of simple ganglion aspiration. We found that 32% of ganglia resolved after aspiration alone in comparison with 22% after aspiration and multiple puncture. This difference was not significant. However, only 18% of patients requested formal surgical excision, suggesting that aspiration allays fears of malignancy and allows the patient to accept a minor cosmetic embarrassment.

The Natural History of Untreated Dorsal Wrist Ganglia and Patient Reported Outcome 6 Years after Intervention

“…Aspiration can be done on its own or combined with multiple punctures. Stephen et al (1999) found no difference in the recurrence rates between these two methods of treatment in a prospective randomised study of 92 patients. Aspiration may be combined with injection of various substances and Nelson et al (1972) published a recurrence rate of 35% to 60% following aspiration and injection of various substances into the ganglion.…”

Arthroscopic Versus Open Dorsal Ganglion Excision: A Prospective, Randomized Comparison of Rates of Recurrence and of Residual Pain

“…2,3,15 Recurrence of the ganglion is the most frequently reported failure of any form of treatment and is believed to result from inadequate excision of the stalk. [3][4][5]11,18 The advent of wrist arthroscopy has provided surgeons with an alternative method of treatment for the symptomatic primary DG. Arthroscopic surgery offers advantages similar to those that have already been achieved for the larger joints of the body, namely the knee and shoulder.…”

“…[1][2][3] Other than observation, nonoperative treatment such as closed rupture, ganglion puncture, and needle aspiration is associated with relatively higher rates of recurrence as high as 78%. [4][5][6] Surgical treatment with either open or arthroscopic excision is therefore offered with a lower risk of recurrence. Whereas open excision has historically been the traditional method of surgical treatment, [1][2][3]7 arthroscopic excision has been suggested as a potentially more favorable alternative.…”

Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

“…Given the evidence to support ultrasound as a diagnostic tool and the ease, cost, and lack of ionizing radiation exposure, the use of ultrasound-guidance in aspiration of these fluid collections should be considered as first-line therapy. Although a discussion of the optimal therapy for various ganglion and synovial cysts is beyond the scope of this review, there is some evidence to support the use of guided aspiration prior to or in lieu of surgical therapy [44] . For infectious indications, the use of ultrasound for both diagnostic and therapeutic purposes is also well described [45][46][47][48][49][50][51][52] .…”