Arthroscopy is a surgical procedure used to diagnose and treat problems inside a joint.
Arthroscopy utilizes a small fiber optic instrument called an arthroscope that enables the surgeon to see inside the joint without making large incisions into the muscle and tissue.
The wrist is a complex joint with eight small bones and many connecting ligaments. Arthroscopic surgery can be used to diagnose and treat a number of conditions of the wrist, including chronic wrist pain, wrist fractures, ganglion cysts, and ligament tears.
Surgeons place portals in specific locations on the wrist, depending on the area that needs to be viewed. This set of portals, called the standard radiocarpal portals, will give access to the wrist. Other sets of portals provide access to other areas of the wrist. (Reproduced with permission from Gupta R, Bozentka DJ, Osterman AL: Wrist Arthroscopy: Principles and Clinical Applications. J. Am Acad. Orthop 2001;9:200-209.)
The surgeon makes small incisions (called portals) through the skin in specific locations around a joint.
These incisions are less than half an inch long. The arthroscope, which is approximately the size of a pencil, is inserted through these incisions. The arthroscope contains a small lens, a miniature camera, and a lighting system.
The three-dimensional images of the joint are projected through the camera onto a television monitor. The surgeon watches the monitor as he or she moves the instrument within the joint.
Probes, forceps, knives, and shavers at the ends of the arthroscope are used to correct problems uncovered by the surgeon.
Diagnostic arthroscopy might be used if it is not clear what is causing wrist pain. It might also be used if wrist pain continues for several months despite nonsurgical treatment.
Before arthroscopic surgery, your doctor will do the following.
Usually, arthroscopic surgery requires only that the hand and arm are numbed (regional anesthesia). A sedative may be given to further relax the patient.
Two or more small incisions (portals) are made on the back of the wrist. The arthroscope and instruments are inserted through those portals and the joint is observed through the camera on the end of the arthroscope.
After the surgery, the incisions are closed with a small stitch and a dressing is applied. Sometimes a splint is used.
Arthroscopic Surgical Treatment
Arthroscopic surgery can be used to treat a number of conditions of the wrist.
This is a view inside a joint using an arthroscope. The TFCC ligament is torn and the surgeon is using a hook to clean the area to make a smooth surface to suture the torn ligament in place. The head of the ulna (U) is visualized through the tear. Next to it is the radius (R). (Reproduced with permission from Gupta R, Bozentka DJ, Osterman AL: Wrist Arthroscopy:
For the first 2 or 3 days after surgery, the wrist should be elevated and the bandage should be kept clean and dry. Ice may help keep swelling down. There are exercises that can be used to help maintain motion and rebuild your strength. Although pain after surgery is usually mild, analgesic
Complications during or after arthroscopic wrist surgery are unusual. They may include infection, nerve injuries, excessive swelling, bleeding, scarring, or tendon tearing. Your doctor will discuss the complications of arthroscopy with you before your surgery.