Anatomical location of volar wrist ganglion in preoperative MRI is a risk factor for operation-related complications after arthroscopic ganglionectomy

Abstract

Background: This study aimed to analyze risk factors of operation-related complications after arthroscopic ganglionectomy in patients with volar wrist ganglions, including patients' demographics and ganglions' anatomical characteristics in MRI. We hypothesized that volar wrist ganglions, either located distal to the bifurcation of the radial artery or superficially expanded, would associate with complications after arthroscopic ganglionectomy.

Methods: This retrospective study included patients who had an arthroscopic ganglionectomy for volar wrist ganglion from Mar 2012 to Feb 2022 and followed up over one year. We reviewed medical records to gather patients' demographics. The preoperative MRI was also examined to analyze the anatomical characteristics of the ganglion, involving axial location, superficial expansion, size, and presence of multiple lesions. The axial location was separated into two entities, whether located proximally or distally from the bifurcation of the radial artery. The superficial expansion was categorized into three depending on deep and superficial fascia penetration. For operation-related complications, we included the partial injury of the radial artery, median or dorsal branch of the radial nerve, and recurrence of ganglions after surgery.

Results: Forty-five patients were enrolled in this study. The partial injury of the radial artery occurred in four patients(8.9%); two were ligated, and others were repaired intraoperatively. The recurrence has occurred in two patients(4.4%). On univariate logistic regression analysis, these complications were associated with the anatomical location of the ganglion when it was distal to the bifurcation of the radial artery and concurrently penetrated up to the superficial fascia layer(p = 0.035). The others were unrelated to complications, including revision surgery, multiple lesions, size, and anatomical locations unless it was concurrent.

Conclusions: The operation-related complications after arthroscopic volar wrist ganglionectomy are associated with its anatomical location when distal to the bifurcation of the radial artery and concurrently penetrated up to the superficial fascia layer.