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Wrist arthroscopy

Wrist arthroscopy is surgery that uses a tiny camera and surgical tools to examine or repair the tissues inside or around your wrist. The camera is called an arthroscope. The procedure allows the doctor to detect problems and make repairs to the wrist without making larger cuts in the skin and tissue. This means that you may have less pain and recover more quickly than open surgery.

Description

You will likely receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you will have regional anesthesia. Your arm and wrist area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

During the procedure, the surgeon does the following:

  • Inserts the arthroscope into your wrist through a small incision. The scope is connected to a video monitor in the operating room. This allows the surgeon to view the inside of your wrist.
  • Inspects all the tissues of your wrist. These tissues include cartilage, bones, tendons, and ligaments.
  • Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage is fixed. Any damaged tissue is removed.

At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues.

Why the Procedure is Performed

You might need wrist arthroscopy if you have one of these problems:

  • Wrist pain: Arthroscopy allows the surgeon to explore what is causing your wrist pain.
  • Ganglionremoval: This is a small, fluid-filled sac that grows from the wrist joint. It is harmless, but it can be painful and can limit your ability to move your wrist freely.
  • Ligament tears: A ligament is a band of tissue that connects bone to bone. Several ligaments in the wrist help keep it stable and allow it to move. Torn ligaments can be repaired with this type of surgery.
  • Carpal tunnel release: Carpal tunnel syndrome occurs when the nerve that passes through certain bones and tissues in your wrist becomes swollen and irritated. With arthroscopy the area through which this nerve passes can be made larger to relieve the pressure and pain.
  • Wrist fractures: Arthroscopy can be used to remove small bits of bone and help realign the bones in your wrist.

Risks

Risks of anesthesia and surgery in general are:

  • Allergic reactions to medicines
  • Breathing problems
  • Bleeding, blood clot, or infection

Risks of wrist arthroscopy are:

  • Failure of surgery to relieve symptoms
  • Failure of repair to heal
  • Weakness of the wrist
  • Injury to a tendon, blood vessel, or nerve

Before the Procedure

Tell your health care provider what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

  • You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other medicines.
  • Ask your provider which medicines you should still take on the day of your surgery.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
  • Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
  • If you smoke, try to stop. Ask your provider or nurse for help. Smoking can slow wound and bone healing.
  • Tell your doctor about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of surgery:

  • Follow instructions about when to stop eating and drinking before the procedure.
  • Take the medicines your provider told you to take with a small sip of water.
  • Follow instructions about when to arrive at the hospital. Arrive on time.

After the Procedure

  • You can go home the same day after spending an hour or so in recovery. You should have someone drive you home.
  • Keep your wrist elevated above your heart for two to three days to help reduce swelling and pain. You can also apply a cold pack to help with swelling.
  • Keep your bandage clean and dry. Follow instructions for how to change the dressing.
  • You can take pain relievers, if needed, as long as your doctor says it's safe to do so.

Outlook (Prognosis)

Arthroscopy uses small cuts in the skin, so compared to regular surgery, you may have:

  • Less pain and stiffness during recovery
  • Fewer complications
  • Faster recovery

The small cuts will heal quickly and you may be able to resume your normal activities in a few days. But, if a lot of tissue in your wrist had to be repaired, it may take several weeks to heal.

You may be shown how to do gentle exercises with your fingers and hand. Your doctor may also recommend that you see a physical therapist to help you regain the full use of your wrist.

Alternative Names

Wrist surgery; Arthroscopy - wrist; Surgery - wrist - arthroscopy; Surgery - wrist - arthroscopic; Carpal tunnel release

References

Geissler WB, Keen CA. Wrist arthroscopy. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 73.

Park MJ, Yao J. Advances in hand and wrist arthroscopy. Plast Reconstr Surg. 2014;134:758e-65e. PMID: 25347651 www.ncbi.nlm.nih.gov/pubmed/25347651.

Update Date 5/9/2015

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