Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan.
Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
J Orthop Sci. 2022 Mar;27(2):389-394. doi: 10.1016/j.jos.2021.01.009. Epub 2021 Mar 4.
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.
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.
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.
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.
关节镜下切除已成为腕关节腱鞘囊肿的首选治疗方法。然而,对于复发性腕关节腱鞘囊肿,关节镜下切除相对禁忌。本研究旨在评估关节镜下切除复发性腕关节腱鞘囊肿的临床疗效,并探讨其安全性和有效性。
2011 年 6 月至 2017 年 2 月,对 17 例复发性腕关节腱鞘囊肿患者采用关节镜下切除治疗。我们在术前和末次随访时采用视觉模拟评分法(VAS)、改良 Mayo 腕关节评分和上肢功能障碍问卷(DASH)评估腕关节功能,并对患者进行回访,了解疼痛缓解情况、俯卧撑时疼痛程度及对重返工作的影响。每次随访时还评估复发和并发症情况。
我们共纳入 17 例患者,中位随访时间为 58 个月。患者术后疼痛明显缓解,17 例患者中仅 2 例仍有残留疼痛。1 例女性患者术后 3 年复发。虽然术后有 2 例出现僵硬,但术后 3 个月时无明显并发症。大多数患者恢复良好,能够重返工作岗位,但有 2 例患者恢复一般。
本研究结果证实,关节镜下切除是治疗复发性腱鞘囊肿的有效且安全的方法,不应作为治疗复发性腕关节腱鞘囊肿的禁忌证。然而,需要进一步开展前瞻性、大样本量的研究以提供更有力的证据支持关节镜下切除复发性腕关节腱鞘囊肿。