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腕关节腱鞘囊肿关节镜下切除术的患者相关结局

Patient-Related Outcomes of Arthroscopic Resection of Ganglion Cysts of the Wrist.

作者信息

d'Ailly Philip N, Koopman Jaimy E, Selles Caroline A, Rahimtoola Zulfiquar O, Schep Niels W L

机构信息

Department of Hand and Trauma Surgery, Maasstad Hospital, Rotterdam, The Netherlands.

Department of Orthopaedic and Trauma Surgery, Royal Berkshire Hospital, Reading, United Kingdom.

出版信息

J Wrist Surg. 2021 Feb;10(1):31-35. doi: 10.1055/s-0040-1716509. Epub 2020 Sep 14.

Abstract

Ganglion cysts of the wrist can cause pain and loss of functionality. No consensus exist on optimal treatment. Arthroscopic resection shows promising results but is poorly studied. Furthermore, only few studies have used patient-related outcomes to evaluate arthroscopic treatment.  The purpose of this study was to assess patient-related outcomes following arthroscopic resection of wrist ganglion cysts.  This was a retrospective study of all consecutive patients that underwent arthroscopic resection of a dorsal or volar wrist ganglion. Minimum follow-up was 6 months. The primary outcome was the patient-rated wrist evaluation (PRWE). Secondary outcomes were recurrence rate and complications.  A total of 53 patients were included with a mean follow-up of 13 months (interquartile range: 6-23 months). Twenty-six patients (49%) presented with a recurrence following prior treatment. Mean PRWE was 13 (standard deviation [SD] = 1.8), with no difference between patients with dorsal or volar ganglion cysts. There were five recurrences (9%), of which three occurred in the first five patients who were operated. There were three patients with complications (6%), consisting of neuropraxia, extensor carpi ulnaris tendinitis, and painful scar tissue.  Arthroscopic resection results in good patient-related outcome and low complication and recurrence rates when performed by an experienced surgeon. Recurrence and complication rates are similar to arthroscopic resections described in literature and superior to open resection and needle aspiration. Well-designed randomized clinical trials will be necessary to confirm these findings.  This is a level IV, retrospective study.

摘要

腕部腱鞘囊肿可导致疼痛和功能丧失。对于最佳治疗方法尚无共识。关节镜下切除术显示出有前景的结果,但相关研究较少。此外,仅有少数研究使用与患者相关的结局来评估关节镜治疗。 本研究的目的是评估腕部腱鞘囊肿关节镜下切除术后与患者相关的结局。 这是一项对所有连续接受背侧或掌侧腕部腱鞘囊肿关节镜下切除术患者的回顾性研究。最短随访时间为6个月。主要结局是患者自评腕部评估(PRWE)。次要结局是复发率和并发症。 共纳入53例患者,平均随访13个月(四分位间距:6 - 23个月)。26例患者(49%)在先前治疗后出现复发。PRWE平均值为13(标准差[SD]=1.8),背侧或掌侧腱鞘囊肿患者之间无差异。有5例复发(9%),其中3例发生在最初接受手术的5例患者中。有3例患者出现并发症(6%),包括神经失用、尺侧腕伸肌腱炎和疼痛性瘢痕组织。 由经验丰富的外科医生进行关节镜下切除术可带来良好的与患者相关的结局,且并发症和复发率较低。复发率和并发症发生率与文献中描述的关节镜下切除术相似,且优于开放切除术和针吸术。需要设计良好的随机临床试验来证实这些发现。 这是一项IV级回顾性研究。

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