Does surgery outperform non-operative treatment for wrist ganglion?
A randomised, parallel-group superiority trial across five hospitals in Finland and Singapore — measuring what matters to patients: pain and function.
Common, often operated — never tested against non-operative care.
Wrist ganglions are the most common soft-tissue tumours of the hand and the most frequently excised. Despite high surgical volumes, no randomised trial has compared operative treatment with non-operative care using patient-reported outcomes as the primary endpoint.
This trial addresses that evidence gap directly, with the PRWHE pain subscale at six months as the primary outcome.
Who can participate?
Patients referred to a participating hand surgery outpatient clinic with a wrist ganglion diagnosis.
Inclusion All required
- Wrist pain in the ganglion area
- Diagnosis of wrist ganglion (clinical examination or imaging)
- Age over 18 years
- Able to complete questionnaires in Finnish or English
Exclusion Any one
- Pregnancy or breastfeeding
- Other known wrist pathology explaining the pain
- Previous surgical treatment of the wrist
- Ganglion presumed related to a work injury
- Symptomatic ganglion on both volar and dorsal sides of the same wrist
If both wrists are symptomatic, the more symptomatic wrist is enrolled.
The participant journey
Every assessment point and what is measured there. Select a variable for its definition, scale and role in the protocol.
Randomisation and baseline questionnaires
Stratified 1:1 allocation by ganglion location and country.
Non-operative
Hand use as tolerated, with self-implemented exercise therapy from day one.
Operative
Resection within two months, followed by the same exercise therapy.
First follow-up questionnaire
Outpatient clinic visit and questionnaire
Non-operative group: crossover to surgery is offered if symptoms persist.
Final follow-up questionnaire
Five centres, two countries
- TAYSTampere University HospitalCoordinating centre · Tampere
- HUSHelsinki University HospitalHelsinki
- OYSOulu University HospitalOulu
- PHKSPäijät-Häme Central HospitalLahti
- NUHSNational University Health SystemSingapore
The trial team
Tampere University HospitalCoordinating centre
Helsinki University HospitalHelsinki
Oulu University HospitalOulu
Päijät-Häme Central HospitalLahti
National University Health SystemSingapore
Protocol & SOPs
Standard Operating Procedures and the full trial protocol govern all study activities. Documents open as PDF in a new tab.
Full trial protocol
Background, design, eligibility, outcomes, statistical plan and ethics
Screening, recruitment & randomisation
Eligibility assessment · informed consent · REDCap baseline and allocation
Surgical intervention
Open and arthroscopic resection · postoperative care · REDCap surgical data entry
Follow-up & data collection
Questionnaire schedule · 6-month clinic visit · adverse events · discontinuation
Shared decision-making tool
Interactive aid for discussing wrist ganglion treatment options with patients
ClinicalTrials.gov entry
GangLion resection effectiveness trial · NCT07162415
Questions about the trial?
For general enquiries, please contact the coordinating principal investigator. For site-specific questions, see each centre’s principal investigator in the trial team.
lasse@gangliontrial.com