Arthroscopy is a surgical procedure used to diagnose and treat problems inside a joint, including the wrist. 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.

Usually, arthroscopic surgery requires only that the hand and arm are numbed (regional anesthesia). A sedative may be given to further relax the patient. After the surgery, the incisions are closed with a small stitch and a dressing is applied. Sometimes a splint is used.

Who Needs It

Patients who suffer from a variety of injuries and conditions of the wrist may benefit from arthroscopic surgery, including:

  • Chronic wrist pain. Arthroscopic exploratory surgery may be used to diagnose the cause of chronic wrist pain when the results of other tests do not provide a clear diagnosis. Often, there may be areas of inflammation, cartilage damage, or other findings after a wrist injury. In some cases, after the diagnosis is made, the condition can be treated arthroscopically as well.
  • Wrist fractures. Small fragments of bone may stay within the joint after a bone breaks (fractures). Wrist arthroscopy can remove these fragments, align the broken pieces of bone, and stabilize them by using pins, wires, or screws.
  • Ligament/TFCC tears. Ligaments are fibrous bands of connective tissue that link or hinge bones. They provide stability and support to the joints. The TFCC is a cushioning structure within the wrist. A fall on an outstretched hand can tear ligaments, the TFCC, or both. The result is pain with movement or a clicking sensation. During arthroscopic surgery, the surgeon can repair the tears.
  • Inflammatory arthritis. Those with extensive synovitis or inflammation of the lining of the joint may benefit from surgical debridement of the joint.

How Does It Work

The surgeon makes small incisions (called portals) through the skin in specific locations around a joint. 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, and shavers inserted through another portal are used to correct problems uncovered by the surgeon.

Recovery

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. Although pain after surgery is usually mild, analgesic medications will help relieve any pain.

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.