International Wrist Center, Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France.
International Wrist Center, Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France.
Hand Surg Rehabil. 2022 Sep;41(4):457-462. doi: 10.1016/j.hansur.2022.04.001. Epub 2022 Apr 28.
We compared arthroscopic cyst resection (ACR) of dorsal ganglia of the wrist, either associated to reconstruction of the dorsal capsuloligamentous scapholunate septum (ACR-DCSS) in 66 cases in which the ganglia were painful on exertion, or isolated ACR in 15 pain-free cases. A single-center retrospective study analyzed data for the period April 2013 to May 2021. The main aim was to compare pre- and post-operative functional results (pain at rest (on a numerical rating scale: NRS), pain under effort (NRS), range of motion (°), grip strength (kg)) and recurrence rate between the two techniques. The study hypothesis was that DCSS repair improves recurrence of dorsal ganglion cyst and functional outcome. The ACR-DCSS group showed significant improvement in extension, pronation, supination, radial inclination, ulnar inclination, grip strength, pain at rest and pain on exertion. The ACR group showed significant improvement in pronation, ulnar inclination and pain on exertion. There was a significant difference in recurrence rate, in favor of ACR-DCSS. Recovery was also significantly better for the ACR-DCSS group in terms of extension, supination and pain at rest. Arthroscopic treatment of wrist ganglion cyst is a reliable, minimally invasive and reproducible technique that produces good results in terms of pain and recovery of range of motion, with significantly lower recurrence rate in case of DCSS repair. Level of evidence: Therapeutic III.
我们比较了腕背侧神经节囊肿切除术(ACR),对于运动时疼痛的 66 例患者,联合背侧囊韧带舟月间隔重建(ACR-DCSS);对于无疼痛的 15 例患者,行单纯 ACR。一项单中心回顾性研究分析了 2013 年 4 月至 2021 年 5 月期间的数据。主要目的是比较两种技术的术前和术后功能结果(静息时疼痛(数字评分量表:NRS)、用力时疼痛(NRS)、活动范围(°)、握力(kg))和复发率。研究假设是 DCSS 修复可改善背侧神经节囊肿的复发和功能结果。ACR-DCSS 组在伸展、旋前、旋后、桡偏、尺偏、握力、静息时疼痛和用力时疼痛方面均有显著改善。ACR 组在旋前、尺偏和用力时疼痛方面有显著改善。在复发率方面,ACR-DCSS 组具有显著优势。在伸展、旋后和静息时疼痛方面,ACR-DCSS 组的恢复情况也明显更好。腕关节神经节囊肿的关节镜治疗是一种可靠、微创和可重复的技术,在疼痛和活动范围恢复方面均取得了良好的效果,在进行 DCSS 修复的情况下,复发率显著降低。证据水平:治疗性 III 级。