Arthroscopy is the visualisation of the interior of a joint by fibreoptic telescope. It is commonly done in the knee and shoulder. Arthroscopy is now routinely performed in the wrist and is useful in a number of conditions.
Wrist arthroscopy is usually performed under general anaesthesia although it may be done under arm block.
It is performed through several small incisions (Portals) on the back of the wrist joint.
The procedure usually takes between 45 minutes and 1 hour. All 3 wrist joints can be examined by wrist arthroscopy but routinely the Radiocarpal & Midcarpal joints are examined.
Radiocarpal Joint
Midcarpal Joint
It in useful for a number of conditions:
- Debridement of tears of the triangular fibrocartilage complex (T.F.C.)
- Removal of loose bodies or scar tissue
- Assessment of the joint surfaces prior to another procedure in the wrist eg Scaspholunate ligament tears.
The procedure involves filling the wrist joint with fluid which helps to distract the joint surfaces. The wrist joint is very small and so a distracting apparatus is usually applied to the fingers and forearm to open the joint up further so adequate and safe visualisation of the inside of the joint is achieved. The distracting device does not involve any further cuts on the arm.
Open wrist operations such an ligament reconstructions are often delayed until the swelling from the fluid instilled into the joint has settled. This may take 2 to 3 weeks.
Post-Operative Treatment
Most patients are able to go home the same day following the arthroscopy. Local anaesthetic is inserted into the joint at the end of the procedure so most patients wake with no pain at all. Usually a plaster slab is applied to the wrist for comfort for a day or two but this can be removed when pain permits. Simple exercises of the wrist are recommenced as soon as pain permits. If an arthroscopic repair of the (T.F.C.) or ligament has been performed then the wrist may well be immobilised for 6 weeks or longer.
It is usually possible to return to most sporting activities within 4 to 6 weeks after a wrist arthroscopy.
Complications
- are very rare following arthroscopic surgery but some possible post-operative complications include infection in the wrist joint or potential damage to tendons, nerves or the joint surfaces. You will be kept under review after your wrist arthroscopy to ensure that any problems arising are promptly treated.
Usually there are no sutures used to close the holes which are covered by small elasticised strips called "Steristrips". These are usually removed at your follow-up one week following the surgery. Please keep the wrist and hand dry until this review.
LAST UPDATED ON 12 / 4 / 2015