The term Arthroscopy means looking inside a joint through a telescope. This is a key hole surgical technique which allows a surgeon to look inside the wrist joint to assess and diagnose the condition of the wrist and at the same time carry out surgical procedures to treat the problem.
A 2.7 mm telescope is used for wrist arthroscopy and it is introduced from the back of the wrist through very small cuts on skin called portals. Three to five such portals are necessary to look at all parts of the joint. Because it is a key hole procedure there is little tissue damage and recovery is swift. The operation is done under general or regional anaesthetic as a day case. The complications of the procedure are few and rare and they include infection and a small risk of tendon damage.
Wrist Arthroscopy is done to diagnose and treat a number of wrist problems. Ulnar wrist pain on the side of the wrist is one of the common conditions caused by ligament damage. This can be assessed and treated by wrist arthroscopy. Other causes of wrist pain such carpal instability, early arthritis, scaphoid fracture can only be fully assessed arthroscopically. MRI scans in these situations are also useful. Unexplained wrist pain when all other investigations are normal is another indication for this operation.
Wrist arthroscopy is sometimes done to diagnose the condition causing the wrist pain. In some patients the pain is quite vague and obscure and despite full examination and investigations, it is not possible to reach a diagnosis. Most of these are soft tissue pains but Arthroscopy helps to exclude a problem with the joint.
Arthroscopy is also done to assess the severity of a condition such as extent of arthritis and amount of damage to ligaments etc.
Some procedures can also be performed arthroscopically and they are listed below
- TFCC defects (ligament injuries)
- Early arthritis (radial styloidectomy and debridement)
- Inflammatory conditions like Rheumatoid arthritis (synovectomy)
- Instability (repair of TFCC)
- Partial injuries of ligaments (debridement)
- Loose bodies (removal)
The operation is done as day case. You will go home with your hand bandaged. It may be necessary to take some pain killers for a day or two. The bandage is reduced after 48 hours and movements are encouraged. Recovery is quick but some swelling may persist for up to a week.
A follow up appointment will be arranged to assess the recovery and also in some cases to start physiotherapy.
FRCS (Trauma & Orth)
Consultant Trauma and Hand Surgeon