Prospective Outcomes of Arthroscopic Versus Open Resection of Dorsal Wrist Ganglions

Introduction: The aim of this prospective randomized study was to compare recurrence, pain and functional scores of the patients operated openly or arthroscopically due to dorsal wrist ganglion with a minimum of 18-month follow-up. Methods: Twenty patients underwent arthroscopic and 20 patients underwent open excision after the failure of conservative treatment for a minimum period of six months. Patients' demographic characteristics, The Disabilities of the Arm, Shoulder and Hand score (QuickDASH), grip strength, Visual Analogue Pain scale (VAS), operation time, incision lengths, recurrence rates and treatment satisfaction rates were compared. Results: In open and arthroscopy groups, age, gender, side distribution and dominant side distribution did not vary significantly (p>0.05). Although the postoperative QuickDASH score and VAS decreased significantly in the open and arthroscopic groups, there was no significant difference between the groups. The duration of operation was significantly higher and the incision length was lower in the arthroscopy group than in the open excision group (p<0.05). In the open and arthroscopic groups, time from diagnosis to surgery, grip strength, the rate of satisfaction with the treatment, and the recurrence rate were not significantly different (p>0.05). Furthermore, we diagnosed scapholunate interosseous ligament tear in seven patients and grade 1 triangular fibrocartilage complex tear in one patient who underwent arthroscopic ganglion excision. In both of the groups, there were two recurrences during follow-ups (10%), which were treated with open excision. Conclusion: Arthroscopic ganglionectomy has the advantages of smaller incisions, diagnosing and intervention of other associated wrist pathologies. Disadvantages are steep learning curve and long operating time.