Surgery With/Without Nerve Cutting for Wrist Ganglion

Enrolling by invitation 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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two methods for treating dorsal wrist ganglion cysts, which are lumps on the wrist that can cause pain and hinder daily activities. One group will have the cyst removed, while the other group will have the cyst removed and a small nerve cut to assess if this reduces pain and improves function. The trial aims to determine which method better reduces pain and enhances wrist movement. Individuals with painful wrist cysts seeking surgery might be suitable candidates for this study. As an unphased trial, it offers patients the opportunity to explore innovative treatment options for wrist cysts.

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 prior data suggests that this surgical method is safe for treating wrist ganglion?

Research has shown that surgically removing a ganglion cyst from the back of the wrist is generally safe, though some risks exist. One study found that the cyst recurred in only 7.5% of cases post-surgery. However, about 14% of patients experienced complications such as ongoing pain and stiffness, necessitating therapy.

For a treatment that includes cutting a small nerve (posterior interosseous neurectomy or PIN) along with the surgery, the safety information remains less clear. Similar nerve procedures have demonstrated results comparable to standard surgery, with good outcomes in reducing pain and improving wrist function.

Overall, both treatments are usually well-tolerated, but like any surgery, side effects can occur. Participants should consider these factors when deciding to join a trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for wrist ganglion because they explore different surgical methods that might offer better outcomes. The standard approach typically involves just removing the ganglion, but one of the treatments in this trial adds a procedure called posterior interosseous neurectomy (PIN). This additional step could potentially reduce the recurrence of the ganglion and improve pain management by targeting specific nerves. By understanding whether the combination of excision with PIN is more effective than excision alone, this trial could lead to more refined and successful surgical options for patients.

What evidence suggests that this trial's treatments could be effective for wrist ganglion?

Research has shown that surgically removing a ganglion cyst from the back of the wrist usually leads to good results. Studies indicate that this method is successful, with fewer cysts recurring and higher patient satisfaction compared to treatments like steroid injections. In this trial, participants will undergo either dorsal wrist ganglion excision alone or with an additional procedure called posterior interosseous neurectomy (PIN), which involves cutting a nerve. Early findings suggest that adding PIN could reduce post-surgery pain and improve wrist movement, making daily tasks easier. However, more research is needed to confirm these benefits. ^{4 5 6 7 8}

Who Is on the Research Team?

Kenneth Taylor, MD

Principal Investigator

Penn State Health Milton S Hershey Medical Center

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9836780/

Surgical and Patient-Centered Outcomes of Open versus ... Based on this systemic review and meta-analysis, we have found arthroscopic excision of ganglion cysts to be favorable when compared with open excision, with ...

2. nature.com nature.com/articles/s41598-025-87960-2

An evaluation of surgical excision versus steroid injection ... Surgical excision demonstrated significantly better outcomes, with higher success and lower recurrence rates than aspiration and steroid injection.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT04932122

Outcomes After Dorsal Wrist Ganglia Excision With or ... The purpose of this study is to determine if a statistical significance exists between outcomes of patients treated for dorsal wrist ganglion cyst with ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12314447/

Comparative Outcomes of Open Surgical Excision for ... Open surgical excision is a successful treatment method for wrist ganglion cysts based on middle and long-term outcomes, with high patient satisfaction and low ...

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/full/10.1111/os.13576

Two‐Year Clinical Outcomes after Arthroscopic Re ... Arthroscopic excision of a recurrent DWG cyst yielded satisfactory results with no second recurrence, significant pain relief, and good wrist function at a ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7850802/

Patient-Related Outcomes of Arthroscopic Resection ... Twenty-six patients (49%) presented with a recurrence following prior treatment. Mean PRWE was 13 (standard deviation [SD] = 1.8), with no difference between ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9836768/

Clinical Results of Arthroscopic Resection of Dorsal Wrist ... In a systematic review and meta-analysis, Head et al found a lower rate of recurrence (21%) but a higher rate of complications (14%) for open surgical excision ...

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0363502315006929

Outcomes of Open Dorsal Wrist Ganglion Excision in Active ... Postoperative outcomes examined were pain persisting greater than 4 weeks after surgery, stiffness requiring formal occupational therapy treatment, surgical ...