Recurrence of Ganglion Cysts Following Re-excision

Document Type : RESEARCH PAPER


1 Department of Orthopedic Surgery, The Rothman Institute, Sidney Kimmel Medical College, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA, USA

2 Department of Neurology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA

3 Unidad Ortopédica de Colombia, Bogota, Colombia

4 Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands


Background: The recurrence of ganglion cysts after surgical excision has a reported rate of 4% to 40%. Recurrence rate
after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts
in patients who underwent a secondary excision procedure.
Methods: With Institutional Review Board approval, we retrospectively identified by CPT code and reviewed charts of
patients who had recurrent ganglion cyst excision performed over a five-year period (2010 – 2014). Recurrence was defined
as reappearance of a cyst in the same area as it was previously. Demographic information including recurrences and
revision surgeries was collected in addition to outcome variables such as patient satisfaction, pain levels, and functional
Results: Out of the 42 revision cases identified 20 patients were reached. Mean time to recurrence of the cyst after the first
ganglion cyst excision was 2.5 years (range: 1 month - 12 years). After the second ganglion cyst excision, three patients
(15%) had a recurrence, each occurring within one year (mean: 11 months; range: 9-12). One of the three patients underwent
a third successful ganglion cyst excision. The other two patients declined surgical intervention to date. Patients without a
second recurrence (n=17) reported an average pain score of 0.1 (range: 0-2) on a scale of 1-10. Three (18%) reported some
difficulty with day-to-day activities due to their scar. Seven (41%) patients reported at least transient numbness or tingling.
Mean satisfaction was 9.8 on a scale of 1-10, and 100% reported that they would undergo another ganglion cyst excision
should they ever have another recurrence.
Conclusion: Patients should be advised about the risk of recurrence after re-excision of ganglion cysts, which was noted
to be 15% in our cohort. This rate of recurrence is similar to that of primarily excised cysts.
Level of evidence: III


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