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A Multi-factorial Analysis of the Recurrence Rate of Ganglion Cysts After Open Excision at UPMC
Landon Myers Cluts, BS, University of Pittsburgh, Pittsburgh, PA and John R. Fowler, MD, Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

Background: The traditional recurrence rate after open excision of wrist ganglion cysts is approximately 20%.  However, this literature is based on small series of subjects.  The current study aims to determine the rate of recurrence and risks of recurrence after open excision of ganglion cysts in a large patient series.

Methods: This study included 628 patients who had ganglion cyst excision between 2010 and 2018. A retrospective chart review recorded the following information: Age, sex, laterality, volar/dorsal location, and whether or not there was a recurrence. An overall recurrence rate was calculated. Additionally, a one-way ANOVA test was used to compare rates of recurrence among the three surgeons included in this study and a series of unpaired T-tests were used to compare age of recurrence, rate of recurrence and side of original cyst, and rate of recurrence between males and females.

Results: The overall recurrence rate was 3.8% (24/628). The recurrence rates for the individual surgeons were 3% (9/353), 2% (3/167), and 11% (12/107), P=0.02 (Table 1). The age of those that had a recurrence versus those that did not have a recurrence was not different (32 years vs 38 years), P=0.06. The recurrence rate for dorsal ganglion cysts was 2.9% (14/341) compared to 3.5% (10/286) for volar ganglion cysts, P=0.69).  Male patients had a recurrence in 6.4% (13/204) of cases compared to 2.6% (11/424) of female patients, P=0.01 (Table 2).

Table 1:

Ganglion Cyst recurrence for Three surgeons and One-Way ANOVA with Calculated P value          

	Recurrences	Total Excised	%	P
Surgeon 1	9	353	3	0.017
Surgeon 2	3	167	2
Surgeon 3	12	107	11

 

Table 2:

Recurrence Rates of Males and Females and the calculate P-Value

	Recurrences	Total		P
Recurrence of Male	13	204	6.37%	0.01
Recurrence of Female	11	424	2.59%

 

Discussion: In our patient sample, male sex was a significant risk factor for the recurrence after open excision of a ganglion cyst. Additionally, the surgeon that performs the operation is a significant risk factor for cyst recurrence. This may be because experience is an important factor in preventing recurrence.