Wrist Surgery: Arthroscopy

Arthroscopy is a surgery that uses a small camera to see the inside of a joint. It can be performed as a wrist surgery to treat a variety of problems in the wrist including pain, swelling, or clicking. These symptoms may mean there is an internal problem of the wrist joint. Sometimes symptoms start after an injury such as a fall or twisting of the wrist. Arthroscopy is a good way to look directly at the injury and repair it. The procedure can be used to help repair a broken wrist, remove a ganglion cyst, wash out infection, or remove excess tissue from various types of inflammation.

Arthroscopy is performed by passing thin instruments into the joint using very small incisions. Pain, swelling, and stiffness are less than with standard, open surgery. Recovery is often faster. The wrist (Figure 1) has become the third most common joint to undergo arthroscopy, after the knee and shoulder.

What types of wrist conditions are treated with arthroscopy?

• Triangular fibrocartilage complex (TFCC) injury or wear
• Ligament injury or wear
• Fractures (broken bones)
• Ganglion cyst
• Inflammatory arthritis

Procedure

During the procedure, a small camera is placed into the wrist joint through a small incision in the skin (Figure 2). The image is projected onto a television screen for better viewing. Several small incisions may be used to allow the surgeon to place the camera in different positions. Special instruments are also inserted through these small incisions to complete the work inside the joint.

The camera allows your surgeon to see cartilage surfaces of the wrist bones, ligaments, and the joint lining.

Some parts of ligaments have a good blood supply and can be repaired. For other ligament problems, the area is shaved and smoothed. Your surgeon may combine wrist arthroscopy with an open procedure that requires a longer incision. This decision depends on the specific condition.