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Chen KP, Ma CH, Wu CH, Jou IM, Tu YK. Arthroscopic resection of recurrent wrist ganglions - A retrospective study of 17 patients. J Orthop Sci 2022; 27:389-394. [PMID: 33676789 DOI: 10.1016/j.jos.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/21/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Arthroscopic resection has become a favorable alternative for wrist ganglions. However, for recurrent wrist ganglions, arthroscopic resection is relatively contraindicated. The purpose of this study was to evaluate the clinical outcomes of arthroscopic resection for recurrent wrist ganglions and to identify their safety and efficacy. METHODS From June 2011 to February 2017, 17 patients with recurrent wrist ganglion were treated with arthroscopic resection. We evaluated the visual analog scale, modified Mayo wrist score, and Disabilities of Arm, Shoulder and Hand Outcome Measure preoperatively and at the final follow-up. Patients were questioned for pain reduction, pain during pushups, and any difficulty in returning to work. Recurrence and complications were also assessed at each follow-up visit. RESULTS We enrolled 17 patients and median follow-up was 58 months. The reduction in pain was significant. Only 2 of the 17 patients had residual pain after arthroscopic resection. One female patient showed recurrences 3 years later. Although 2 cases of stiffness were noted after the operation, no significant complication was present 3 months postoperatively. Most patients had good recovery and could resume work; however, 2 patients reported fair recovery. CONCLUSION The results of this study confirmed that arthroscopic excision could be an effective and safe treatment for recurrent ganglions; therefore, should not be contraindicated for treating recurrent wrist ganglions. Nevertheless, further prospective studies with larger patient numbers are needed to establish a stronger evidence for arthroscopic resection of recurrent wrist ganglions.
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Affiliation(s)
- Kuan-Po Chen
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan.
| | - Ching-Hou Ma
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Chin-Hsien Wu
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - I-Ming Jou
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Yuan-Kun Tu
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
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Yin YB, Liu B, Zhu J, Chen SL. Clinical and Epidemiological Features Among Patients with Wrist Arthroscopy Surgery: A Hospital-based Study in China. Orthop Surg 2020; 12:1223-1229. [PMID: 32725748 PMCID: PMC7454219 DOI: 10.1111/os.12746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/03/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022] Open
Abstract
Propose To analyze the clinical and epidemiological features of patients who underwent wrist arthroscopy procedures. Methods This is a cross‐sectional epidemiological study. The study included a cohort of patients who underwent wrist arthroscopy procedures in a national orthopaedic referral center from 1 February, 2014 to 1 February, 2019. The medical records, diagnosis, and every wrist arthroscopy procedure of all the patients were collected and reviewed. The epidemiological features, detail of the diagnoses, and the procedures of all the patients were systemically analyzed. All the patients were divided into two groups: trauma and non‐trauma conditions. The complexity of the wrist arthroscopy procedure was classified into simple procedures (exploration or debridement) and complex procedures (repair or reconstruction). χ2 test was used to compare proportions between the procedures of different complexity and the two groups of patients. Results A total of 533 patients (332 males and 201 females) were included in this study. More than half (56%) of the patients were in the age group 21–40 and nearly two thirds (62%) of all the 533 patients were male. The diagnoses of all the patients could be classified into eight categories: (i) TFCC injury; (ii) ulnar impactions syndrome; (iii) carpal trauma (carpal bone fractures and/or carpal ligament injures); (iv) distal radius fractures; (v) carpal bone cyst or necrosis; (vi) ganglion cyst; (vii) wrist arthritis; and (viii) disorders of small joint of the hand. The most common conditions treated with wrist arthroscopy were TFCC injury (172 cases), followed by carpal trauma (125 cases) and ulnar impaction syndrome (84 cases). The simple arthroscopic procedures (exploration or debridement) account for 53% of all the procedures while complex reparative or reconstructive procedures account for 47%. There was a significant difference in the proportion between simple procedures and complex procedures in both trauma and non‐traumatic patients. Repair or reconstruction procedures were more frequently performed for wrist trauma patients, whereas exploration or debridement procedures were more frequently performed for non‐trauma patients. Conclusions The largest group of patients who underwent wrist arthroscopy surgery are those who complained of ulnar‐sided wrist pain and the commonly conducted wrist arthroscopy procedures have evolved from simple exploration/debridement to the more complex repair or reconstruction procedures in China.
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Affiliation(s)
- Yao-Bin Yin
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Bo Liu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Jing Zhu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Shan-Lin Chen
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
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Yen CY, Ma CH, Wu CH, Yang SC, Jou IM, Tu YK. A cost and efficacy analysis of performing arthroscopic excision of wrist ganglions under wide-awake anaesthesia versus general anaesthesia. BMC Musculoskelet Disord 2020; 21:459. [PMID: 32660448 PMCID: PMC7359493 DOI: 10.1186/s12891-020-03482-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Arthroscopic excision has currently become popular for the treatment of wrist ganglions. The objective of this study was to evaluate the clinical outcomes and cost effectiveness of arthroscopic wrist ganglion excisions under Wide-Awake Local Anaesthesia No Tourniquet versus general anaesthesia. Methods We retrospectively reviewed patients who underwent arthroscopic ganglionectomy from April 2009 to October 2016 at our institute. They were separated into two groups according to anaesthesia techniques: general anaesthesia and Wide-Awake Local Anaesthesia No Tourniquet. We compared the clinical outcomes and cost-effectiveness of the two groups. Results Seventy-four patients were included. Both groups were matched with regard to the demographics and preoperative clinical assessments. We found no significant differences between groups in postoperative visual analog scale, modified Mayo wrist score, Disabilities of Arm, Shoulder and Hand score, recurrence, residual pain, or complications. Recurrence was found in five of 74 patients, one (4.3%) in the Wide-Awake Local Anaesthesia No Tourniquet group and four (7.8%) in the general anaesthesia group. One extensor tendon injury and four extensor tenosynovitis cases occurred in the general anaesthesia group. Regarding cost effectiveness, the mean operating time in the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were 88.7 ± 24.51 and 121.5 ± 25.75 min, respectively (p < 0.001). The average total costs of the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were €487.4 ± 89.15 and €878.7 ± 182.13, respectively (p < 0.001). Conclusions For arthroscopic wrist ganglion resections, both anaesthesia techniques were effective and safe regarding recurrence rates, complications, and residual pain. The most important finding of this study was that arthroscopic ganglionectomy under Wide-Awake Local Anaesthesia No Tourniquet was superior to that under general anaesthesia for cost-effectiveness. Level of evidence Level III, Retrospective comparative study.
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Affiliation(s)
- Cheng-Yo Yen
- Department of Orthopedics, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan
| | - Ching-Hou Ma
- School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan.,Department of Orthopedics, E-Da Hospital, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan
| | - Chin-Hsien Wu
- School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan. .,Department of Orthopedics, E-Da Hospital, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan.
| | - Shih-Chieh Yang
- School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan.,Department of Orthopedics, E-Da Hospital, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan
| | - I-Ming Jou
- School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan.,Department of Orthopedics, E-Da Hospital, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan
| | - Yuan-Kun Tu
- School of Medicine, College of Medicine, I-Shou University, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan.,Department of Orthopedics, E-Da Hospital, No.1, E-Da Road, Yan-Chau District, 824, Kaohsiung City, Taiwan
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