Wrist arthroscopy is also known as keyhole wrist surgery. It involves inserting a small telescope, approximately 3mm in diameter, into the wrist joint to assess and sometimes treat problems inside the wrist.
Many people are familiar with arthroscopy of larger joints such as the knee and shoulder, but the same type of keyhole surgery can also be performed in the wrist joint.
Mr Robert Farnell is an experienced specialist Consultant Orthopaedic Hand and Wrist Surgeon who has been working in Leeds for over
25 years. He exclusively treats conditions affecting the adult hand and wrist, including wrist pain, wrist ligament injuries, TFCC injuries, scaphoid problems and wrist arthritis.
What is wrist arthroscopy?
Wrist arthroscopy is a minimally invasive operation which allows the surgeon to look directly inside the wrist joint using a small camera.
The procedure is performed through small incisions at the back of the wrist. The arthroscope is inserted into the joint and the images are displayed on a screen, allowing detailed assessment of the internal wrist structures.
Wrist arthroscopy is usually performed as a day case procedure using either general anaesthesia or regional anaesthesia, where the arm is temporarily anaesthetised.
Why is wrist arthroscopy performed?
Wrist arthroscopy enables the surgeon to visually assess the structures inside the wrist joint. These include the strong wrist ligaments, the triangular fibrocartilage complex, also known as the TFCC, the synovium or joint lining, and the joint surfaces.
It can be useful when symptoms, examination findings and scans suggest a problem inside the wrist joint, particularly if symptoms have not improved with non-surgical treatment.
Conditions assessed or treated with wrist arthroscopy
Wrist arthroscopy may be used to assess or treat several wrist conditions, including:
- Persistent wrist pain
- TFCC tears
- Scapholunate ligament injuries
- Wrist ligament injuries
- Inflammation of the joint lining
- Loose bodies within the wrist joint
- Early wrist arthritis
- Cartilage or joint surface problems
In some cases, treatment can be carried out at the same time using fine instruments which are inserted through additional small incisions in the skin.
What happens during wrist arthroscopy?
The operation is performed in theatre under sterile conditions. Small incisions are made at the back of the wrist to allow the arthroscope and fine instruments to enter the wrist joint.
The surgeon examines the inside of the wrist and assesses the ligaments, TFCC, synovium and joint surfaces. If appropriate, treatment may be performed at the same time.
The operation is usually well tolerated and most patients go home on the same day.
After wrist arthroscopy
After the operation, a dressing is applied to the wrist. This usually remains in place for up to two weeks.
Once the dressing has been removed and the wounds have healed, the wrist can usually be freely mobilised, although the exact advice depends on what was found and treated during the procedure.
Read more about post-operative care.
Recovery after wrist arthroscopy
Wrist arthroscopy is usually not very painful. There may be some swelling, stiffness or bruising around the wrist after surgery, but this generally improves gradually.
The procedure usually leaves two or three small scars at the back of the wrist where the arthroscope and instruments were inserted.
Recovery depends on the condition being treated. If the procedure is purely diagnostic, recovery is usually quicker. If a ligament, TFCC or joint problem is treated at the same time, recovery may take longer and hand therapy may be recommended.
Possible complications
Postoperative complications are recognised but fortunately uncommon.
Possible complications include:
- Wound infection
- Temporary scar tenderness
- Wrist stiffness
- Tendon injury
- Nerve injury
- Persistent wrist pain, depending on the underlying condition
Outcome after wrist arthroscopy
The outcome depends on the underlying condition being assessed or treated. Wrist arthroscopy is a useful way of directly visualising the inside of the wrist and, in some cases, treating the problem through small incisions.
Mr Farnell will discuss the likely recovery, restrictions and expected outcome based on the findings at surgery and the treatment performed.
Considering keyhole wrist surgery?
If you have persistent wrist pain, suspected ligament damage or a possible TFCC injury, Mr Robert Farnell can assess your wrist and advise whether wrist arthroscopy may be appropriate.
Wrist arthroscopy FAQs
What is wrist arthroscopy?
Wrist arthroscopy is keyhole surgery of the wrist. A small telescope is inserted into the wrist joint to assess and sometimes treat problems inside the joint.
Is wrist arthroscopy the same as keyhole wrist surgery?
Yes. Wrist arthroscopy is commonly referred to as keyhole wrist surgery.
What conditions can wrist arthroscopy assess?
Wrist arthroscopy can assess the wrist ligaments, TFCC, synovium, joint surfaces, cartilage and other structures inside the wrist joint.
Can wrist arthroscopy treat TFCC injuries?
Yes. Some TFCC injuries can be assessed and treated using wrist arthroscopy, depending on the type and location of the tear.
Is wrist arthroscopy painful?
The operation is generally well tolerated and is usually not very painful.
How many scars does wrist arthroscopy leave?
Wrist arthroscopy usually leaves two or three small scars at the back of the wrist.
How long does the dressing stay on?
A dressing is usually applied to the wrist for up to two weeks after surgery.
When can the wrist move after arthroscopy?
In many cases, the wrist can be mobilised once the dressing has been removed, although this depends on what was treated during surgery.
What are the risks of wrist arthroscopy?
Risks are uncommon but include infection, tendon or nerve injury, scar tenderness and wrist stiffness.