Ganglion cyst on r-wrist/diagnosed osteoarthritis Surgery?

[hydranga]

I have had a ganglion cyst on right wrist for about 2 years. In July, 2003, had it drained and had a cortizone shot in the cyst. Felt better for a couple of months. It continued, so saw the hand surgeon. He did an xray, and found osteoarthritis (no cartilage in the wrist joint) in my wrist and did a cortizone shot in the wrist, not the cyst. This was in January 2004. I continued to have problems with the cyst, which is now about 2 inches, bulging on the inside of my wrist, and making manual tasks very difficult. It throbs a lot, haven't been able to play golf. So I saw the hand surgeon again in May 2004. And he said it would not help to remove the cyst, if, as he believes, it is caused by the arthritis in the wrist.. He recommended surgery to take a piece of a tendon in my wrist to use as a spacer between the wrist joints. It would be a 2 day inpatient hospital stay, a cast on my wrist for 4 weeks, and then  6 months of rehabiliation.
Yikes! What do you know about this ?

[Kevin Pho, MD]

Without being familiar with your case personally, I cannot make any comments.  Ganglion cysts are soft, fluid-filled cysts can develop on the front or back of the hand for no apparent reason.  They certainly can be removed if your surgeon suspects this is the cause of your pain.  

If the reason is wrist osteoarthritis, the treatment is more difficult. One consideration would be to stiffen the wrist - known as a wrist fusion. This usually eliminates the pain and increases the strength, but prevents movement in the wrist. After the operation, to keep the wrist still for 6–8 weeks a lightweight cast will be fitted, but your fingers will be free for eating or writing. The hospital stay is for a few days only.

I am not familiar with the procedure that is described.  However, most wrist surgeries require an extended course of rehabilitation, so the times quoted are not unreasonable.  Before going through the surgery, you may want to consider another opinion.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b