Summary

Your wrist is a complex joint with 8 small bones with their connecting ligaments. Wrist arthroscopy is a keyhole surgery that involves inserting a small thin camera called an arthroscope through a small cut in your wrist. Your surgeon will place portals (small cuts) to the back of your wrist in specific locations. This allows your hand surgeon to look inside the two main joints of your wrist and to diagnose and treat wrist injuries and problems using a tiny camera and surgical tools

Wrist arthroscopy is usually performed under a general anaesthesia although it can be done under an arm block. The surgeon will do several small cuts on the back of your wrist joint. The procedure should take between 45 minutes and 1 hour.

In my practice I do it most commonly for TFCC tears (triangular fibrocartilage complex). TFCC is a cushioning structure to the ulna side of your wrist. During arthroscopic surgery, the surgeon can repair the TFCC tears or debride them. Other reasons I do a wrist arthroscopy is for a ganglion cysts around the wrist, to diagnose arthritis in the wrist, for chronic wrist pain and occasionally for
fractures.

Triangular fibro cartilage complex is a cartilage cushion structure located on the small finger side of the wrist that cushions and supports the small carpal bones in the wrist. A tear to TFCC can happen with a fall on an outstretched hand. This can then result in chronic wrist pain.

Acute TFCC tears operated within 3 months of injury can give up to 80-90% excellent results with 80- 90% grip strength and range of motion compared to the other wrist. Delayed repair gives less predictable results.

You will be seen by an anaesthetist who will discuss anaesthetic complications with you. Your surgeon will take you through the consent process. Once you are in the operating room you will be given antibiotics and general anaesthesia.

Surgery involves making several cuts on the back of your wrist from which the camera and arthroscopic instruments are inserted. An assessment is then made of the relevant structures inside the wrist joint. Then depending on the indication for the arthroscopy, treatment is done like removal of loose bodies, removal of any bits of bone or cartilage or inflammed lining of wrist joint, release of capsule, TFCC debridement, ganglion excision, assessment of arthritis etc.

At the end the skin portals will be stitched up and you will come out into recovery in a bulky dressing and a sling.

In my practice, TFCC is the most common indication for which I would offer my patients wrist arthroscopy.

After wrist arthroscopic surgery you will be sent to the recovery room. Your wrist will be covered in a protective bandage and you will be in a sling. You will be in recovery for a few hours and then you will be allowed to go home with pain medication. You will also see a hand therapist on the day of your surgery who will show you range of motion exercises to your wrist and discuss further rehabilitation. The bulky bandage will come off in two days. You will have to keep the wound dry for two weeks at which stage you will see your consultant for a wound check and removal of sutures. Your wrist will improve within 3-6 months depending on the procedure.

The complications are minimal which may include infection, damage to the skin nerves, swelling, bleeding, stiffness, scarring and occasionally damage to the tendons. These will be discussed with you in the clinic and on the day of surgery and a consent form will be completed with you.