Wrist Arthroscopy

What is it?
When is it performed?
How?
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What is wrist arthroscopy?

Arthroscopy, from “arthros,” the Greek word for “joint,” can be broadly defined as a minimally invasive procedure that entails the insertion of a thin fiber-optic tube equipped with a camera into the interior of any joint in the body. Its purpose is to allow an enhanced view of internal structures and, if indicated, to perform surgery with the aid of that visualization. In practice, the surgery is most often performed on the knee, shoulder or wrist, and it is perhaps best known as a procedure performed on the vulnerable knees of professional athletes.

The arthroscope itself is a thin fiber-optic tube that is inserted into the joint through a small incision, providing a magnified image that can be viewed on a monitor. If surgery is to be performed, the surgeon inserts miniature surgical instruments through a second small incision and uses the enlarged image to perform the appropriate procedure.

When is the procedure needed?

Arthroscopy can be used to assess the condition of the wrist, especially where other diagnostic options have been inconclusive, or to treat problems that have not responded to non-surgical intervention.

For assessment purposes, arthroscopy provides a better and more detailed view than X-ray or MRI images, especially of wrist cartilage and ligaments. Given the complexity of the wrist’s anatomy, it can be difficult to determine the causes of pain, swelling or functional issues from a static view, but arthroscopy can be used to view internal structures in motion.

The need for wrist arthroscopy surgery parallels the assessment situation, as it often follows the unsuccessful use of other treatment modalities. It may also be a treatment of first resort in order to remove wrist ganglions, reduce a wrist fracture or repair damage that was itself disclosed by the arthroscopic evaluation.

What are the common injuries requiring the procedure?

Wrist arthroscopy is commonly used to treat fractures of the wrist and torn ligaments and cartilage, but it has also been employed to treat repetitive stress injury that has not responded to rest, physical therapy or to the use of braces. As an assessment tool, it has been used to evaluate arthritic conditions.

How is wrist arthroscopy surgery done?

Surgery is generally an outpatient procedure that may be performed under regional or general anesthesia. The arthroscope is inserted into the back of the wrist through a “portal,” an incision that is 3 mm long. Additional incisions may be made in order to accommodate different views and the wrist is filled with a fluid to improve visibility. Once the surgeon has evaluated the situation, instruments are introduced into the wrist, where they can be used to repair torn ligaments, remove inflamed tissue, smooth areas of bone and suture inside the joint.

Recovery Time

Recovery time is significantly less than is expected after an open procedure. Most patients are fitted with a brace that allows finger movement and that will remain in place for one to two weeks. The time it takes to recover fully varies greatly, depending on the nature and extent of the surgery, but will generally take at least several weeks.