Ganglions are cyst-like, benign lumps that develop near joints and tendons, particularly in the hand, wrist and foot.
They may fluctuate in size- becoming larger at times and smaller again at other times. They can result from local wear and tear on ligaments and joints.
Non-operative management techniques are associated with high rates of recurrence. Needle aspiration with injection of agents like hyalase to breakdown the contents and lining of the ganlion can be effective, but surgery remains the most effective management for ganglions that do not respond to conservative techniques.
Ganglions can be removed during day surgery but can have recurrence rates as high as 40% if the original cause is not identified and treated (e.g. a weakness in a joint capsule with leakage of joint fluid).
In most cases you will see a visible lump, however smaller ganglion cysts can be hidden beneath the skin.
While symptoms are limited, a cyst can apply pressure on nearby joints, making the extremes of movement uncomfortable and may occasionally cause compression of nerves, resulting in pain, tingling and muscle weakness.
Large cysts may not be painful, but they can cause concern due to their appearance.
When non-surgical alternatives are not helpful, you may require surgery to remove a ganglion.
During this procedure the surgeon will remove the cyst wall, fluid and stalk. Some of the joint capsule or tendon sheath may also need to be removed.
Even though surgery is generally successful, ganglions can reoccur. If they do, they can either be observed for a period, or removed again.
Consult your RPS surgeon for advice regarding your individual condition.
What can I expect after my ganglion hand operation?
Your incision will be closed with dissolving sutures in most cases. Your hand will then be dressed with heavy dressing which you will need to keep dry.
You can go home the same day, but you will need someone to collect you from the hospital.
To assist the healing process it’s important not to lift anything with your operated hand in the first two weeks, no matter how small the object. This means you may have to take at least two weeks off work if your job requires any kind of lifting.
After two weeks you can increase activity, but still no heavy lifting for a total of six weeks. Manual workers may have to have up to six weeks off work after this type of hand surgery. You will be eligible for a medical certificate.
We will usually review your wound in the first 1-2 weeks, but this can be done by your GP if it is more convenient. Then, six weeks post-surgery you will have an appointment with your surgeon to assess the function of your hand or fingers.
Ganglions are often described as water balloons on a straw. The straw is connected to a joint or tendon sheath. They are filled with a clear, gel-like fluid that is rich in a material called glycosaminoglycans.
The size of the cyst can increase or decrease as the joint or tendon sheath produces fluid.
Ganglions are not cancerous and may vanish over time. They can’t spread to other areas of your body.
Younger people aged 15 to 40 are more susceptible to ganglion cysts. Women also seem to be more affected.
They are also more common in individuals who apply repeated stress to their wrist.
There are other non-surgical treatments for ganglion cysts.
Surgery may be required if these treatments are unsuccessful.
As with any surgery, complications can arise, these include:
Your RPS surgeon will give you specific advice regarding your individual post-operative recovery. They will advise:
The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.
Dr Michael Findlay holds an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.
