Wrist Arthroscopy
WHAT IS WRIST ARTHOSCOPY?
The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joint.” Arthroscopy sounds similar to endoscopy but the term arthroscopy limits the designation to within a joint compared to the similar tools used outside of a joint. Orthopedic surgeons use arthroscopy as a minimally invasive surgical tool to diagnose and treat ailments inside of a joint. Originally, surgeons would not consider small joints such as the wrist for arthroscopic surgical intervention. However, due to advances in technology and success with large joints surgeons can utilize wrist arthroscopy for specific conditions. The wrist contains 8 bones and many ligaments to connect them to each other; the complexity of the wrist makes it a good candidate for minimally invasive repairs. Arthroscopy enables the surgeon to see the anatomic parts and their movements without making large incisions into the muscle and tissue. Surgeons often use arthroscopy for two purposes: to make more accurate diagnoses (diagnostic arthroscopy) and to correct any problems with the joint. A minimally invasive procedure, wrist arthroscopy, involves a few small incisions and the inflation of the joint with sterile liquid. The surgeon inserts a light and camera that transmit the image to a monitor in one incision and rotates tools as needed for debriding, cutting, grinding, and heating, in the other entry points. With a small incision a surgeon can remove bone spurs, repair and replace cartilage, debride frayed tendons, tighten up connective tissues, anchor down ligaments and tendons, diagnose previously un-diagnosable issues, and even set bones. The possibilities seem to not stop growing.
Arthroscopic surgery has value as a diagnostic and treatment tool. Arthroscopy damages less tissue because compared to open surgery it requires only a few smaller incisions. Patients receiving minimally invasive surgery, such as wrist arthroscopy, generally have fewer problems and a more rapid recovery than regular open surgery. Surgeons generally perform wrist arthroscopy as an outpatient procedure sending most patients home just a few hours after surgery.
When is wrist arthroscopy appropriate?
The field of wrist arthroscopy has grown over time increasing the amount of conditions treated. Currently physicians consider the following conditions for the possible use of wrist arthroscopy:
- Injuries to the Triangular Fibrocartilage complex (TFCC)
- ulnocarpal impaction
- excision of dorsal wrist ganglia
- some distal radius and scaphoid fractures requiring bone setting assistance
- debridement of chondral lesions
- synovectomy
- diagnosis in unexplained mechanical wrist pain
- removal of loose bodies
- assistance in treatment of SNAC and or SLAC wrist
- interosseous ligament injuries
- septic wrist irrigation and debridement
Recovery from Wrist Arthroscopy
Patients receiving an intervention that utilizes wrist arthroscopy generally receive a cast, splint or other soft dressing. The exact procedure preformed will require a specific dressing to suit the needs of the patient’s recovery. Most arthroscopic procedures have a level of physical therapy or rehab to some degree or another as well as recovery times unique to the repair made.
