Arthroscopically assisted treatment of intraosseous ganglions of the lunate: a new technique

Abstract

Purpose: A minimally invasive technique of debridement and grafting the intraosseous ganglions of the lunate was investigated.

Materials and methods: Eight patients with persistent symptoms and typical radiographic and bone scan findings were assessed independently pre- and postoperatively by using a modified Green and O'Brien wrist score. The intraosseous cyst was drilled under arthroscopic and fluoroscopic guidance via either a volar or dorsal portal, depending on the position identified on the computed tomography scan. Average follow-up time was 3.8 years (range, 1-5.6 years).

Results: All patients returned to employment within 4 months. Wrist scores improved 34 points, from 51 to 85 points, by 1 year after surgery with trabeculation being noted within the grafting lunate. The greatest improvements were seen in visual and analog pain scores, reducing from 68.3 to 11.2, and flexion-extension arcs, which increased from 98 degrees to 114 degrees.

Conclusions: The technique of debridement of intraosseous ganglions of the lunate is safe, with minimal morbidity and recurrence of symptoms during the follow-up period.