Download PDF
J Wrist Surg 2023; 12(01): 018-022
DOI: 10.1055/s-0042-1744367
Scientific Article

Dorsal Wrist Ganglion: Pilot for Randomized Control Trial Comparing Aspiration Alone or Combined with Injection of Platelet-Rich Plasma

Katharine Hamlin 
1   Department of Upper Limb Unit, Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
,
Alexandra Haddon
1   Department of Upper Limb Unit, Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
,
Yasmeen Khan
1   Department of Upper Limb Unit, Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
,
Clare Miller
1   Department of Upper Limb Unit, Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
,
David Lawrie
1   Department of Upper Limb Unit, Orthopaedics, Woodend Hospital, Aberdeen, United Kingdom
› Author Affiliations Funding This work was supported by Arthrex, with the provision of ACP double syringes.
› Further Information
   Permissions and Reprints

Abstract

This pilot study assessed the feasibility of performing a randomized control trial (RCT) investigating injection with platelet-rich plasma (PRP) for dorsal wrist ganglion (DWG). Aspiration alone was compared with aspiration plus injection of PRP. Seventeen patients were enrolled. Nine patients received PRP and eight aspiration alone. Patients were followed up at 6 weeks and 1 year; recurrence of the ganglion and Patient Evaluation Measure scores were measured. At 6 weeks seven patients in the aspiration group had a recurrence and five in the PRP group, but by 1 year, this has increased to seven out of eight in the PRP group whereas in the aspiration group four had resolved leaving three out of eight patients with a ganglion still present. From the basis of our work an RCT would require a minimum of 46 patients per group; however, it is unlikely that PRP will be a panacea for ganglia. This is a Level II study.

Keywords

platelet-rich plasma - ganglion - aspiration - wrist - dorsal

Note

The trial was registered on clinicaltrials.gov—Record Number: 1/091/17 (NCT03408808).


Ethical Approval

The research protocol was approved in advance by the Wales Research Ethics Committee 5. REC Reference: 17/WA/0425. Only anonymized data are presented and therefore no specific consent is required.


Authors' Contributions

K.H.: Design of protocol, data acquisition, and write up; Y.K.: Data analysis and write up; A.H.: Randomization, data analysis; C.M.: Protocol design; and D.L.: Protocol design and write up.




Publication History

Received: 03 November 2021

Accepted: 31 January 2022

Article published online:
08 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Athanasian EA, Green DP, Hotchkiss RN, Pederson WC, Wolfe SW. Green's Operative Hand Surgery. 5th ed. Philadelphia: Churchill Livingstone; 2005: 2211-2265
    Google Scholar
  • 2 Psaila JV, Mansel RE. The surface ultrastructure of ganglia. J Bone Joint Surg Br 1978; 60-B (02) 228-233
    CrossrefPubMedGoogle Scholar
  • 3 Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med 2008; 1 (3-4): 205-211
    CrossrefPubMedGoogle Scholar
  • 4 Angelides AC, Wallace PF. The dorsal ganglion of the wrist: its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg Am 1976; 1 (03) 228-235
    CrossrefPubMedGoogle Scholar
  • 5 Janzon L, Niechajev IA. Wrist ganglia. Incidence and recurrence rate after operation. Scand J Plast Reconstr Surg 1981; 15 (01) 53-56
    PubMedGoogle Scholar
  • 6 Lowden CM, Attiah M, Garvin G, Macdermid JC, Osman S, Faber KJ. The prevalence of wrist ganglia in an asymptomatic population: magnetic resonance evaluation. J Hand Surg [Br] 2005; 30 (03) 302-306
    CrossrefPubMedGoogle Scholar
  • 7 Westbrook AP, Stephen AB, Oni J, Davis TR. Ganglia: the patient's perception. J Hand Surg [Br] 2000; 25 (06) 566-567
    CrossrefPubMedGoogle Scholar
  • 8 Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radical excision. J Hand Surg Am 1988; 13 (02) 187-191
    CrossrefPubMedGoogle Scholar
  • 9 Osterwalder JJ, Widrig R, Stober R, Gächter A. Diagnostic validity of ultrasound in patients with persistent wrist pain and suspected occult ganglion. J Hand Surg Am 1997; 22 (06) 1034-1040
    CrossrefPubMedGoogle Scholar
  • 10 Goldsmith S, Yang SS. Magnetic resonance imaging in the diagnosis of occult dorsal wrist ganglions. J Hand Surg Eur Vol 2008; 33 (05) 595-599
    CrossrefPubMedGoogle Scholar
  • 11 Valente Duarte de Sousa IC, Tosti A, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs 2013; 22 (05) 573-589
    CrossrefPubMedGoogle Scholar
  • 12 Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci 2011; 121 (04) 176-180
    CrossrefPubMedGoogle Scholar
  • 13 Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP?. Implant Dent 2001; 10 (04) 225-228
    CrossrefPubMedGoogle Scholar
  • 14 Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 2004; 62 (04) 489-496
    CrossrefPubMedGoogle Scholar