How is the Surgery Performed?

The ganglion usually arises from a stalk that connects it to a tendon or a joint. The fluid in the ganglion is pumped out of the bag that encloses the tendon which provides lubrication, or from the lining of the joint. The surgery aims to take away the sac of fluid, and also to prevent the ganglion from re-arising by removing some of the lining of the joint to encourage scarring, which usually prevents the fluid escaping again.

A cut is made in the skin and the bag of fluid is removed. Sometimes, there are nerves or blood vessels stretched under the ganglion and all attempts are made to preserve these.

The chances of a ganglion reoccuring are around 5%,  so there is a 95% chance that the ganglion will not recur.

If there is a worn out joint nearby, then the pain associated from a ganglion may be coming from the joint, and sometimes it is necessary to fuse the joint to deal with the cause of the pain. This can make the procedure bigger.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.

Risks of Surgery

Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

fluid inside the ganglion

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