Surgical treatment may be needed for a ganglion that has not responded to nonsurgical treatment and:

  • Is painful.
  • Interferes with activity or motion.
  • Causes changes in sensation.
  • Becomes unsightly.
  • Is causing damage to wrist bones, finger bones, or ligaments.
Ganglion Cyst Wrist
Ganglion Cyst Wrist
Ganglion Cyst Foot
Ganglion Cyst Foot

The goal of surgery is to remove the ganglion sac and the connecting tissue that allows the fluid to collect.

Surgical removal of a ganglion is an outpatient procedure.

  • The area around the ganglion is cleaned with an antiseptic.
  • A local anaesthetic is injected to numb the area or a regional anaesthetic is injected to numb the whole arm and hand. (General anaesthetic is not usually used because the surgery does not take long and affects only the wrist or hand.)
  • A cuff (tourniquet), similar to the kind used for taking blood pressure, is placed on the upper arm. This is inflated before the procedure to decrease the blood flow to the hand and wrist.
  • An incision is made at the ganglion site. The surgeon is careful to protect nerves,tendons, ligaments, and blood vessels while removing the ganglion sac and the connecting tissue.
  • The incision is closed with stitches, and a bandage and (in some cases) a splint are applied to restrict movement and allow the incision to heal. Some surgeons encourage moving your wrist 3 to 5 days after surgery to prevent stiffness.

Infection and injury to other tissues are rare, but possible, risks of surgery.

Ganglions return in about 5% to 10% of people after surgery. This may happen if the connecting tissue is not completely removed. New ganglions may also form in the area.

In a mucous cyst ganglion, bone spurs (small, bony growths that form along a joint) are often present in the joint next to the cyst, and removing bone spurs makes it less likely that the cyst will return. The chance of infection is higher in mucous cysts.

Call (+65) 6471 2674 (24  Hour) to make an appointment with our orthopaedic surgeon regarding your ganglion today.

Meniscus Tear Type

Meniscectomy is the surgical removal of all or part of a torn meniscus. A meniscus tear is a common knee joint injury. Surgeons who perform meniscectomies (orthopaedic surgeons) will make surgical decisions based on the meniscus’s ability to heal as well as your age, health, and activity level.

Your doctor will likely suggest the treatment that he or she thinks will work best for you based on where the tear is, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.

  • If you have a small tear at the outer edge of the meniscus (in what doctors call thered zone), you may want to try home treatment. These tears often heal with rest.
  • If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
  • If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work.
  • If you have a tear in the white zone of the meniscus, repair surgery usually isn’t done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.

There are different types of meniscus tears. The pattern of the tear may determine whether a tear can be repaired. Horizontal and flap tears typically require surgical removal of at least part of the meniscus.

Meniscus Tear Type

How Meniscectomy done for a Meniscus Tear

The choice of type of surgery is based on the size and location of the tear, your age and activity level, the surgeon’s experience, and your preferences. Orthopedic surgeons most often perform meniscus surgery with arthroscopy, a procedure used to both examine and repair the inside of a joint. A thin tube (arthroscope) containing a camera and light is inserted through small incisions near the joint. Surgical instruments are inserted through other small incisions. Arthroscopic surgery may limit knee damage from surgery and may promote fuller recovery. But some tears may require open knee surgery.

Knee arthroscopy external view

In a total meniscectomy, the entire meniscus is removed. In a partial meniscectomy, the surgeon removes as little of the meniscus as possible. Unstable meniscal fragments are removed, and the remaining meniscus edges are smoothed so that there are no frayed ends.

You may have general or regional anaesthesia for a meniscectomy. Arthroscopic partial meniscectomy is commonly done in an outpatient surgical center.

What To Expect After Meniscectomy for a Meniscus Tear

Rehabilitation (rehab) varies depending on the injury, the type of surgery, your orthopaedic surgeon’s preference, and your age, health status, and activities. Time periods vary, but meniscus surgery is usually followed by a period of rest, walking, and selected exercises. Most people who have arthroscopic meniscectomy can bear weight a day or two after surgery and can return to full activity within 2 to 4 weeks. After the full range of motion without pain is possible, you can return to your previous activity level.

The timetable for returning to walking, driving, and more vigorous activities will depend on the type and extent of the surgery and your success in rehab.

Why Meniscectomy Is Done

A decision to remove all or part of your meniscus will take into consideration the location, length, tear pattern, and stability of the tear as well as the condition of the whole meniscus. Your surgeon will also consider the condition of the entire knee, your age, and any age- or injury-related degeneration.

If a meniscus tear is causing pain or swelling, it probably means that torn pieces of the meniscus need to be removed and the edges surgically shaved to make the remaining meniscus smooth. Your orthopaedic surgeon will try to preserve as much meniscal tissue as possible to prevent long-term degeneration of your knee and allow you to return to full activities.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our orthopaedic specialist regarding meniscectomy today.

A meniscus tear is a common injury to the cartilage that stabilizes and cushions the knee joint. The type of the tear can determine whether your tear can be repaired. Radial tears sometimes can be repaired, depending on where they are located. Horizontal, flap, long-standing, and degenerative tears – those caused by years of wear and tear – generally cannot be repaired.

Your doctor will likely suggest the treatment that he or she thinks will work best for you based on the zone where the tear is, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see the how strong the meniscus is, where the tear is, and how big the tear is.

Repair of the Meniscus

  • If you have a small tear at the outer edge of the meniscus, you may want to try home treatment. These tears often heal with rest.
  • If you have a moderate to large tear at the outer edge of the meniscus, you may want to think about surgery. These kinds of tears tend to heal well after surgery.
  • If you have a tear that spreads into the inner two-thirds of the meniscus, your decision is harder. Surgery to repair these kinds of tears may not work.
  • If you have a tear in the meniscus, repair surgery usually isn’t done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.

Our surgeon uses arthroscopic surgery to repair the meniscus. The surgeon inserts a thin tube (arthroscope) containing a camera and a light through small incisions near the knee and is able to see inside the knee without making a large incision. Surgical instruments can be inserted through other small incisions. The surgeon repairs the meniscus using sutures (stitches).

Knee arthroscopy external view

Other knee injuries—most commonly to the anterior cruciate ligament (ACL)—may occur at the same time as a torn meniscus. In these cases, the treatment plan is altered. Typically, your orthopedist will repair your torn meniscus, if needed, at the same time ACL surgery is done. In this case, the ACL rehabilitation plan is followed.

What To Expect After Meniscus Repair

Your surgeon may recommend that you limit the motion before you resume to daily activities. Physical therapy may or may not be necessary after the surgery. But heavy stresses, such as running and squats, should be postponed for some months. You must follow your doctor’s rehabilitation (rehab) plan for optimum healing.

Why It Meniscus Repair Is Done

How your doctor treats a meniscus tear depends upon the size and location of the tear, your age, your health and activity level, and when the injury occurred. Treatment options include nonsurgical treatment with rest, ice, compression, elevation, and physical therapy and surgical repair. If the meniscus can be repaired successfully, saving the injured meniscus by doing a meniscal repair reduces the occurrence of knee-joint degeneration.

Small tears located at the outer edge of the meniscus often heal on their own. Larger tears located toward the center of the meniscus may not heal well, because blood supply to that area is poor. In a young person, surgery to repair the tear may be the first choice, because it may restore function.

What To Think About

If surgical meniscus repair is indicated, the procedure should be done as soon as possible after the injury. But if the tear is minor and you choose to put off a surgery to see if the meniscus tear heals on its own, a later repair may still heal the meniscus properly.

You may be able to prevent long-term complications such as osteoarthritis with successful surgical repair of your tear. Successful meniscus repair may save meniscal cartilage and reduce the stress put on the knee joint, thereby lowering the risk of osteoarthritis.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our orthopaedic surgeon regarding your meniscus tear today.

Tennis Elbow

Surgery for tennis elbow may involve:

  • Cutting (releasing) the tendon.
  • Removing inflamed tissue from the tendon.
  • Repairing (reattaching) tendon tears if it is possible to do so without overtightening the tendon.

Surgery may be done using arthroscopy, traditional open surgery, or a combination of the two techniques, depending on the type of problem and the method the doctor prefers to use.

Surgery can be done with general or regional anaesthetic and can be done as a day surgery or an overnight stay in the hospital.

Tennis Elbow
Tennis Elbow

What To Expect After Tennis Elbow Surgery

Recovery varies from person to person.

  • Cigarette smoking slows tendon and wound healing.
  • Recovery depends on the amount of time and effort you put into a rehabilitation program.
  • You may not be able to keep doing the activity that caused your tennis elbow. Or you may have to make some changes to the way you do that activity in the future.

Why Surgery for Tennis Elbow Is Done

You and your doctor may consider surgery if:

  • You still have elbow soreness and pain after more than 6 to 12 months of non-surgical treatment.
  • Corticosteroid shots have given good short-term pain relief but the pain has returned.
  • You cannot perform daily tasks and activities because of elbow pain.

How Well Tennis Elbow Surgery Works

Various surgical procedures are used to treat tennis elbow. 

Most people are able to return to their previous activities after tennis elbow surgery. Be sure to change any previous technique, equipment, or activity that has been linked to the elbow pain.

What To Think About

Surgery for tennis elbow is seldom needed because the condition usually improves with tendon rest and nonsurgical treatment like shockwave therapy or platelet rich plasma therapy.

Call (+65) 6471 2674 (24 Hour) if you wish to see our doctor and discuss the surgery for tennis elbow further.

A bite injury may need to be closed by a health professional, may require antibiotic medicines, or both. The decision to close a wound with stitches, staples, or skin adhesive depends on:

  • The type of biting animal.
  • The size and location of the bite.
  • The time that has passed since the bite occurred.
  • The general health of the person bitten.

It is important to determine if your wound needs to be closed by a health professional. Your risk of infection increases the longer the wound remains untreated. Most wounds that require treatment should be stitched, stapled, or closed with skin adhesives (also called liquid stitches) within 6 to 8 hours after the injury. Some wounds that require treatment can be closed as long as 24 hours after the injury. If stitches may be needed, avoid using an antiseptic or antibiotic ointment until after a doctor has examined the wound.

  • Most dog bites can be stitched, especially if the wound is large.
  • In general, cat bites are not stitched. Cat bites are usually puncture wounds and can be quite deep. Cat bites have a higher risk of infection than dog bites.
  • Most facial bites can be safely stitched. The risk of infection to the face is lower because the face normally has good blood flow. Because of good blood flow, a face wound may heal faster if it is stitched as soon as possible after a bite.
  • Bites to the hand or foot, whether from an animal, are generally not stitched. These bites carry a high risk of infection, and stitching the wound further increases the likelihood of infection. In some situations, a dog bite to the hand may be stitched.

When Should I See A Doctor?:

  • Bites that are more than 0.25 in. (6.5 mm) deep, that have jagged edges, or that gape open.
  • Deep bites that go down to the fat, muscle, bone, or other deep structures.
  • Deep bites over a joint, especially if the bite opens when the joint is moved or if pulling apart the edges of the bite reveals fat, muscle, bone, or joint structures.
  • Deep bites on the hand or fingers.
  • Bites on the face, lips, or any area where scarring may be a concern (for cosmetic reasons). Bites on the eyelids often need sutures for both functional and cosmetic reasons.
  • Bites longer than 0.75 in. (20 mm) that are deeper than 0.25 in. (6.5 mm) when the edges are pulled apart.
  • Bites that continue to bleed after 15 minutes of direct pressure.

Bites such as these should be evaluated by a health professional, but they may not always need stitching.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our doctor regarding animal bites today.