Surgery With/Without Nerve Cutting for Wrist Ganglion

Recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kenneth Taylor, M.D.

Disqualifiers: Chronic wrist instability, Neurologic maladies, Prior wrist surgery, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

32 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of this treatment for wrist ganglion?

Research shows that after surgery to remove a wrist ganglion, patients often experience less pain, better wrist movement, and improved grip strength. These improvements were seen in studies where patients were followed for several months after the procedure. ^{1 2 3 4 5}

Is surgery for dorsal wrist ganglion safe?

Surgery to remove a dorsal wrist ganglion is generally safe, with studies showing no surgical complications or recurrences. Patients often experience improvements in wrist pain, range of motion, and grip strength after the procedure. ^{1 2 3 4 6}

How does the treatment of dorsal wrist ganglion with or without nerve cutting differ from other treatments?

This treatment is unique because it involves the option of cutting a nerve (PIN) during surgery, which may help reduce pain or recurrence, unlike standard excision methods that do not address nerve involvement. ^{1 2 3 4 5}

What is the purpose of this trial?

The purpose of this study is to determine if a statistical significance exists between outcomes of patients treated for dorsal wrist ganglion cyst with excision alone versus excision and the addition of a partial wrist denervation by resecting the common terminal sensory branch of the PIN (posterior interosseus nerve). Our hypothesis is that addition of PIN improves outcome after dorsal wrist ganglion excision as indicated by post-operative pain, function, ability to perform activities of daily living, and physical exam findings.

Research Team

Kenneth Taylor, MD

Principal Investigator

Penn State Health Milton S Hershey Medical Center

Eligibility Criteria

This trial is for adults over 18 with painful dorsal wrist ganglion cysts affecting daily activities. Candidates must speak and understand English, be non-prisoners, able to follow the study plan, and have chosen surgery for their condition. It excludes those under 18, non-English speakers, prisoners, cognitively impaired individuals, anyone with prior wrist surgery or chronic instability in the affected wrist, neurological issues in that wrist, or who are pregnant.

Inclusion Criteria

Fluent in written and spoken English

I have chosen surgery to treat my ganglion cyst.

I understand the study and agree to follow all its procedures and visits.

Exclusion Criteria

Prisoners

I have had wrist surgery on one or both of my arms.

I have nerve-related health issues in the limb that needs surgery.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery

Participants undergo dorsal wrist ganglion excision with or without partial wrist denervation

1 day

1 visit (in-person)

Post-operative Monitoring

Participants are monitored post-operatively with surveys and physical examinations

12 months

Visits at 2 weeks, 12 weeks, 6 months, and 1 year

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Dorsal wrist ganglion alone (DWG)
• DWG/PIN

Trial Overview The study compares two surgical methods for treating dorsal wrist ganglions: excision alone (DWG) versus excision plus partial denervation by cutting a sensory nerve branch (DWG/PIN). The goal is to see if adding nerve resection improves pain relief and function post-surgery.

Participant Groups

Group I: Dorsal wrist ganglion alone (DWG) Active Control 1 Intervention

Dorsal wrist ganglion excision alone

Group II: DWG with PIN Active Control 1 Intervention

Dorsal wrist ganglion excision with posterior interosseus neurectomy (PIN)

Who Is Running the Clinical Trial?

Kenneth Taylor, M.D.

Lead Sponsor

Trials

3

Recruited

90+

References

1. United States pubmed.ncbi.nlm.nih.gov

Immobilization of the Wrist After Dorsal Wrist Ganglion Excision: A Systematic Review and Survey of Current Practice. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Arthroscopic dorsal wrist ganglion excision with color-aided visualization of the stalk: minimum 1-year follow-up. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Prospective Evaluation of Push-up Performance and Patient-Reported Outcomes Following Open Dorsal Wrist Ganglion Excision in the Active-Duty Military Population. [2023]

5. Australia pubmed.ncbi.nlm.nih.gov

Two-Year Clinical Outcomes after Arthroscopic Re-Excision of Recurrent Dorsal Wrist Ganglion Cyst. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Epidemiology of Symptomatic Dorsal Wrist Ganglia in Active Duty Military and Civilian Populations. [2022]