Wrist Arthroscopy

What is a wrist arthroscopy?

Wrist arthroscopy is a type of keyhole surgery that is performed so the surgeon can see inside the wrist joint. An arthroscopy is usually done when there has been trauma to the wrist either from a fall or other injury where the wrist has been twisted and the patient is experiencing pain, clicking, or swelling of the wrist. These symptoms highlight a possible internal problem with the joint.

Arthroscopy involves inserting a telescope into the joint which is connected to a camera so the inside of the joint can be viewed in detail on a monitor. Arthroscopy uses a small fibre optic instrument called an arthroscope that allows the surgeon to see inside the joint without making large incisions into the tissue and muscle.

Via very small incisions, we use specially designed instruments to insert into the joint which enables us to perform many procedures on various structures within the joint.

Wrist arthroscopy is a common operation as it provides a good view of the internal wrist joint.

Arthroscopy allows the surgeon to make small incisions called portals through the skin in certain locations around the joint. The arthroscope, which is no bigger than a pencil, is then inserted through the incisions.

A television monitor then projects three-dimensional images of the joint so the surgeon can watch as he moves the arthroscope inside the joint. He can correct any problems he diagnoses by using the forceps, knives, probes and shavers found at the ends of the arthroscope.

Conditions that are commonly treated using wrist arthroscopy include:

Triangular fibrocartilage

This is a tear of the structure on the little finger side of the wrist where patients may report trauma to the wrist, or it can develop over time. Patients usually experience pain on that side of the wrist, frequently made worse by holding a weight or a twisting movement.

Partial tears of ligament

Tears to cartilage or ligaments of the wrist are caused by either acute trauma or repetitive use and the most common cause of injury to cartilage/ligaments of the wrist is a hard fall with the palm side down on an outstretched arm or from excessive twisting at the wrist. Any type of injury to the wrist can affect the stability of the joint resulting in increased pressure on the ligaments and cartilage. This pressure builds up over time and the joint can no longer compensate leaving the patient experiencing pain and a reduction in the range of movement. Common symptoms resulting from damage to the ligaments/cartilage are pain and swelling of the wrist. The pain can worsen with activity or a particular movement and can result in weakness and a clicking or snapping sound.

How are cartilage and ligament tears of the wrist treated?

Tears to both ligaments and cartilage can be treated non-surgically using splinting for a period of 4-6 weeks, providing the wrist is stable. Anti-inflammatory medication can also be administered to help reduce pain and inflammation.

However, if the injury does not respond to conservative treatment, then surgery is recommended, and a wrist arthroscopy can be performed.

After injury, the ligaments of the wrist begin to heal, tighten, and scar. The build-up of scar tissue can affect the re-alignment of the bone, but can be repaired using reconstruction, pinning or fusion depending on the length of time since the injury first happened.

Pinning can be a successful surgical option if surgery is performed within three months of sustaining the injury. Pinning is where the surgeon uses metal pins to hold the bones in place whilst the ligament heals. The pins are then removed after 8 weeks.

Recovery

An arthroscopy is usually a day case procedure, meaning you will be able to go home on the same day of your operation. It is performed under general anaesthetic, which can cause you to feel lightheaded or dizzy as it wears off, so you will need someone to drive you home and stay with you up to 24 hours after your surgery. You may be given a sling or splint to use to support and protect the joint during recovery.

Dressings will be in place for 5-10 days after the operation and should be kept as dry as possible, using a plastic bag to protect them whilst bathing or showering. If your dressings do get wet or fall off, they will need to be replaced.

Your stitches can be removed between 1-2 weeks post-surgery and you will receive an outpatient’s appointment where a nurse will do this for you.

Your surgeon will see you approximately 8 weeks after your procedure and discuss the results of the operation and your recovery. If your surgeon thinks you need hand therapy to further aid your recovery, they will discuss this with you at your appointment and will arrange it for you.

Returning to normal activities will depend on your recovery and the type of job that you do. Your surgeon will advise you how quickly you can return to doing the things you enjoy doing.

You may only need a week to two weeks off work if you recover quickly. However, if your job involves manual labour or strenuous activity, your surgeon may advise you to take longer off work to protect the joint whilst it is healing.

Complications

Complications from surgery are rare but they can occur, and it is important to recognise early signs that there may be a problem.

If you experience any of the following, please contact your surgeon or visit your GP as soon as possible. The following symptoms can indicate a complication:

Fever
Pain that is worsening
Swelling and redness that is getting worse
Numbness or tingling
Unpleasant smelling discharge coming from your wound

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Wrist Arthroscopy

What is a wrist arthroscopy?

Conditions that are commonly treated using wrist arthroscopy include:

Triangular fibrocartilage

Partial tears of ligament

How are cartilage and ligament tears of the wrist treated?

Recovery

Complications

Whatever your hand or wrist condition is, we can help.

Get in touch