Comparative Effectiveness of Arthroscopic Versus Open Excision for Wrist Ganglion Cysts: A Meta-analysis and Literature Review

Abstract

Introduction: Wrist ganglion cysts are common benign lesions that may cause pain or dysfunction. While open and arthroscopic excision are standard surgical treatments, debate persists regarding their comparative outcomes, recurrence, and complication rates. Aim: This meta-analysis aimed to synthesize the current body of literature comparing open and arthroscopic excision for the treatment of wrist ganglion cysts. Methods: A systematic search of PubMed, Embase, Google Scholar, and Cochrane Library (2010–2025) was performed to identify comparative clinical studies on arthroscopic versus open excision for wrist ganglion cysts. Studies meeting predefined PICO criteria were screened, assessed for quality using the Cochrane RoB tool, and included for meta-analysis. Results and Discussion: Three cohort studies involving 157 patients met the inclusion criteria for meta-analysis. No statistically significant differences were found between arthroscopic and open excision in terms of pain (VAS), functional score, recurrence, or complication rates. Although trends favored arthroscopy in some outcomes, the evidence remains inconclusive and warrants further investigation. This meta-analysis suggests arthroscopic excision may offer lower recurrence and complication rates compared to open surgery for wrist ganglion cysts. While pain and function outcomes were similar, differences in complication profiles and technical variability highlight the need for individualized treatment decisions and further standardized, high-quality comparative research. Conclusion: Both arthroscopic and open excision yield comparable outcomes for wrist ganglion cysts. However, due to limited data and variability, further high-quality studies are needed to clarify definitive clinical superiority. The overall evidence suggests both procedures offer comparable outcomes. However, given the limited number of studies and variability in reporting, further high-quality research is needed to determine the true clinical advantages of one technique over the other.