Randomised Controlled Trial

Does surgery outperform
non-operative treatment
for wrist ganglion?

A multicentre, randomised, parallel-group superiority trial

Enrolled participants
of 220
26Finland
Singapore
Background

Why this trial?

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.

Prior studies focused almost exclusively on ganglion recurrence — not on pain, disability, or patient satisfaction. This trial addresses that evidence gap directly, with the PRWHE pain subscale at 6 months as the primary outcome.

Trial at a glance
220
Participants
3
Study centres
12 months
Follow-up
Registration
NCT07162415
ClinicalTrials.gov
Eligibility

Who can participate?

Patients referred to a participating hand surgery outpatient clinic with a wrist ganglion diagnosis. If both wrists are symptomatic, the more symptomatic wrist is enrolled.

✓ Inclusion criteria

  • Wrist pain in the ganglion area
  • Diagnosis of wrist ganglion (clinical examination or imaging)
  • Age > 18 years
  • Able to complete questionnaires in Finnish or English

× Exclusion criteria

  • 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
Outcomes & Follow-up

Participant timeline

Every assessment point and its measured variables — tap any variable for its definition, scale, and role in the protocol.

Baseline
Baseline — enrolment

Randomisation + baseline questionnaires

PRWHE total PRWHE pain PRWHE function EQ VAS

Stratified 1:1 allocation (ganglion location, country).

0–2 mo
Non-operative

Hand use as tolerated · self-implemented exercise therapy from day one

Operative

Resection within 2 months · same exercise therapy postoperatively

Surgeon prediction (exploratory)
3 mo
3 months — both groups

First follow-up — REDCap questionnaire

PRWHE total PRWHE pain PRWHE function EQ VAS Global improvement PASS Adverse events
★ 6 mo
★ 6 months — primary endpoint

Outpatient clinic visit + questionnaire

★ PRWHE pain — primary outcome PRWHE total PRWHE function EQ VAS Global improvement PASS Ganglion presence Sick leave Adverse events

Non-operative group: crossover to surgery offered if symptoms persist.

12 mo
12 months — final

Final follow-up — REDCap questionnaire

PRWHE total PRWHE pain PRWHE function EQ VAS Global improvement PASS Adverse events

Study Sites

Participating centres

Investigators

Trial team

LL
Principal Investigator · Coordinating Centre
Lasse Linnanmäki
Tampere University Hospital
lasse@gangliontrial.com
TK
Trial Methodologist · Coordinating Centre
Teemu Karjalainen
Tampere University Hospital
teemu@gangliontrial.com
JJ
Investigator
Jarkko Jokihaara
Tampere University Hospital
PN
Principal Investigator
Panu Nordback
Helsinki University Hospital
panu@gangliontrial.com
TA
Investigator
Turkka Anttila
Helsinki University Hospital
AC
Principal Investigator
Alphonsus KS Chong
National University Health System, Singapore
alphonsus@gangliontrial.com
AC
Investigator
Ashley Chua
National University Health System, Singapore
Contact

Questions about the trial?

For general enquiries about the GangLion trial, please contact the coordinating principal investigator.

LL
Lasse Linnanmäki
Coordinating Principal Investigator · Tampere University Hospital
lasse@gangliontrial.com

For site-specific questions, see the trial team for each centre’s principal investigator.