Arthroscopic Dorsal Ligamentocapsulodesis in the Treatment of Occult Dorsal Wrist Ganglion Cysts Associated with Scapholunate Instability: Surgical Technique and Preliminary Clinical Results

Author:

AYIK Ömer1,DEMİREL Mehmet1,UĞURLAR Meriç2,ÖZÇELİK İsmail Bülent3

Affiliation:

1. Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University, Istanbul, Turkey

2. Department of Orthopaedics and Traumatology, Kolan Hospital, İstanbul, Turkey

3. Department of Orthopedics and Traumatology, Gaziosmanpaşa Hospital, Yeni Yüzyıl University, Gaziosmanpaşa, Istanbul, Turkey

Abstract

Background: This study aimed to evaluate our preliminary results and experience with the arthroscopic dorsal ligamentocapsulodesis in managing occult dorsal wrist ganglion cysts (ODGCs) associated with scapholunate (SL) instability. Methods: All patients who underwent arthroscopic dorsal ligamentocapsulodesis due to an ODGC with concomitant SL ligament tear were retrospectively reviewed. In addition to demographic data and length of follow-up, outcomes data that included range of motion, grip strength, modified Mayo wrist score (MMWS), complications and radiographs were collected. Results: The study included 18 patients (18 wrists; 10 female and 8 male). The mean age was 32 years (range: 19–48) and the mean follow-up was 34 months (range: 24–48). The mean preoperative extension deficit decreased from 5.5° (range: 0°–20°) to 2.7° (range: 0°–15°) at the final follow-up (p = 0.004). The mean preoperative flexion deficits decreased from 4.4° (range: 0°–15°) to 2.2° (range: 0°–10°) postoperatively (p = 0.003). The mean hand grip strength significantly increased from 27.7 kg (range: 22–36) to 38.3 kg (range: 31–46) at the final follow-up assessment (p < 0.001). The mean MMWS improved from 46 (range: 25–65) pre-operatively to 91 (range: 70–100) at the final follow-up (p = 0.0002). No major intra- or postoperative complications were observed. Conclusions: SL instability may have an important role in the aetiology of ODGCs, and arthroscopic dorsal ligamentocapsulodesis can provide pain relief and functional improvement without recurrence at the short- to mid-term follow-up in the treatment of ODGCs. Level of Evidence: Level IV (Therapeutic)

Publisher

World Scientific Pub Co Pte Ltd

Subject

General Medicine

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