Wrist arthroscopy is a surgery that allows a doctor to see the inside of a joint. It is performed after a patient sustains an injury such as a fall or a twisting of the wrist and is experiencing pain, clicks or swelling. These symptoms may mean there is an internal problem of the wrist. Arthroscopy is often the best way of directly looking at the injury and repairing it. The procedure can be used to help align fractures of the wrist, remove some ganglions of the wrist, wash out infection, or remove excess joint lining associated with inflammation from conditions like rheumatoid arthritis.
In the last five years, the wrist (Figure 1) has become the third most common joint to undergo arthroscopy, after the knee and shoulder. Because the cuts used with this procedure are smaller and disrupt less soft tissue than typical surgery, pain, swelling and stiffness are minimal, and recovery is often faster.
Your doctor can see the ligaments and cartilage surfaces of bones with wrist arthroscopy. Some parts of ligaments have a good blood supply and can be repaired and heal, whereas other parts do not have a blood supply and don’t heal, so they are removed.
During the procedure, a small camera fixed to the end of a narrow tube is placed through a small cut in the skin directly into the back of the wrist joint (Figure 2). The image is projected onto a television screen for better viewing. Several small cuts are used to allow the surgeon to place the camera in a number of positions to see the cartilage of each bone, the ligaments and the joint lining called synovium.
Risks of this surgery can include but are not limited to:
- Damage to nerves, tendons or cartilage
- Stiffness or loss of joint motion
- Stiffness can be addressed post-surgery with rehabilitation.
After your surgery, you will be placed in a bandage that may prevent wrist motion. This will protect the area and provide pain relief. Arthroscopy most likely does not require an overnight hospital stay. Fingers should move freely, and finger movement is often encouraged to limit swelling and stiffness. Your surgeon will provide instructions on caring for your wound, therapy, safe activities and any work or exercise restrictions. Elevating the wrist is important to prevent swelling and pain after surgery.