Arthroscopical Debridement and Grafting of Intra-Osseous Ganglia of the Lunate

Intraosseous ganglia of the lunate are relatively rare. When persistent pain and discomfort occur, surgical options may be chosen.
We describe 2 such cases. Arthroscopic debridement and grafting was performed after typical radiographic and bone scan findings were assessed. The intraosseous cyst was drilled and autologous bone was impacted in the cavity, using an appropriate cannula under arthroscopic guidance.
No complications occurred. Short term residual pain was minimal (visual analogue scale 2) and mobility and grip strength increased to 90%, compared to the contralateral side, after 4 months. Professional and recreational activities
were fully recuperated after 4 months, leading to high patient satisfaction. Control MRI scans showed adequate bone graft incorporation.
No recurrence of symptoms or cyst formation were noted after 1 year of follow-up. The technique of arthroscopic debridement is a valid alternative to the traditional treatment of open curettage and bone grafting, possibly leading to decreased ongoing pain and stiffness of the wrist, with minimal morbidity and recurrence of symptoms during the follow-up period. Functional recovery and excellent cosmetic results give high patient satisfaction.