Clinical outcomes after arthroscopic revision excision of recurrent dorsal wrist ganglion cyst: a case series study

Background: The recurrence of dorsal wrist ganglion (DWG) cyst following excision has been reported up to 40%. This study aimed to evaluate clinical outcomes regarding the functional evaluation and recurrence rate after the arthroscopic excision of recurrent DWG cysts. Methods From November 2017 to March 2020, 11 consecutive patients diagnosed as recurrent DWG cysts underwent revision excision in an arthroscopic approach. The magnetic resonance imaging (MRI) examination was performed routinely before the surgery to identify the location and limits of the cyst. All patients were followed up for a minimum of 2 years. The second recurrence was recorded if a mass reappeared at the same site, with a positive transillumination test. Pain during activity was evaluated by the visual analog scale (VAS). Active range of motion (ROM) of the wrist was measured by a goniometer, and the hand grip strength was measured using a digital dynamometer. Results After a mean follow-up period of 29.3 months (range, 24 to 34 months), no second recurrence of the cyst was recorded. The VAS score improved from 1.4 to 0.3 (P = 0.003), and the residual pain was reported by 3 patients (VAS score was 1 for each). The active wrist flexion increased from 73.6° to 78.2° (P = 0.016). No significant change was found in active wrist extension and hand grip strength (P > 0.05). Conclusion Arthroscopic excision of recurrent DWG cyst yielded satisfactory results with no second recurrence, significant pain relief, and good wrist function at a minimum 2-year follow-up. Clear identification of the location and limits of the ganglion based on the preoperative MRI could be helpful to achieve a complete excision and to prevent a second recurrence.