Our Summary

The research paper is a guide for plastic surgeons about wrist arthroscopy, a surgical procedure used to diagnose and treat various wrist problems. It is less invasive than traditional surgery. The paper discusses when to use this procedure, when not to, and the relevant anatomy involved. It also explains how to perform the procedure, including creating an entry point, evaluating the problem, and using arthroscopic tools. The paper stresses the importance of identifying crucial structures in the wrist, improving ways to visualize these structures, and how to deal with potential complications. Following these systematic approaches and best practices can help surgeons improve results and broaden their skill set in dealing with complex wrist conditions.

FAQs

  1. What is wrist arthroscopy and what are its uses?
  2. What are the key structures to identify in the radiocarpal and midcarpal joints during a wrist arthroscopy?
  3. What are best practices to adhere to for achieving improved outcomes in managing complex wrist conditions through wrist arthroscopy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy is to follow all post-operative instructions carefully, including keeping the wrist elevated and applying ice as directed to reduce swelling and pain. It is also important to attend all follow-up appointments to ensure proper healing and rehabilitation.

Suitable For

Patients who are typically recommended for wrist arthroscopy include those with:

  1. Persistent wrist pain or swelling that has not responded to conservative treatments such as rest, physical therapy, or medication.
  2. Suspected ligament injuries, such as scapholunate ligament tears or triangular fibrocartilage complex (TFCC) injuries.
  3. Suspected cartilage damage or osteoarthritis in the wrist joint.
  4. Ganglion cysts or other benign wrist tumors.
  5. Suspected wrist fractures or non-unions that may require surgical intervention.
  6. Synovitis or inflammatory conditions affecting the wrist joint.
  7. Evaluation of wrist instability or chronic dislocations.
  8. Evaluation of wrist deformities or malalignment.
  9. Evaluation of chronic wrist pain of unknown etiology.
  10. Monitoring and follow-up of previous wrist surgeries or procedures.

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if wrist arthroscopy is the appropriate course of action for their specific condition.

Timeline

Before wrist arthroscopy:

  • Patient undergoes a thorough evaluation by a hand surgeon to determine the need for wrist arthroscopy.
  • Diagnostic tests such as X-rays, MRI, or CT scans may be performed to assess the extent of the wrist pathology.
  • Surgical consent is obtained from the patient after discussing the risks and benefits of the procedure.

During wrist arthroscopy:

  • Patient is placed under anesthesia to ensure comfort during the procedure.
  • Small incisions are made in the wrist to allow for insertion of the arthroscope and other surgical instruments.
  • The surgeon navigates the arthroscope through the wrist joint to visualize and evaluate the structures within the joint.
  • Any necessary repairs, debridement, or other procedures are performed as needed.

After wrist arthroscopy:

  • Patient is monitored in the recovery room to ensure they are stable and comfortable.
  • Pain management medications may be prescribed to help with any discomfort following the procedure.
  • Physical therapy or rehabilitation may be recommended to aid in the recovery process and regain strength and mobility in the wrist.
  • Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns or complications.

What to Ask Your Doctor

  1. What are the specific benefits of wrist arthroscopy compared to traditional surgical approaches for my condition?
  2. What are the potential risks and complications associated with wrist arthroscopy?
  3. How long is the recovery time after wrist arthroscopy and what can I expect during the rehabilitation process?
  4. How many wrist arthroscopy procedures have you performed and what is your success rate?
  5. Are there any alternative treatment options to consider before undergoing wrist arthroscopy?
  6. Will I need any additional imaging or tests before the wrist arthroscopy procedure?
  7. What type of anesthesia will be used during the wrist arthroscopy procedure?
  8. How long will the wrist arthroscopy procedure take and will I need to stay in the hospital overnight?
  9. What can I do to prepare for the wrist arthroscopy procedure in terms of medications, diet, and activity level?
  10. What can I expect in terms of pain management after the wrist arthroscopy procedure?

Reference

Authors: Stephens KL, Stephens SH, Newson C, Chappell AG, DeGeorge BR Jr. Journal: Ann Plast Surg. 2025 Jun 1;94(6S Suppl 4):S584-S588. doi: 10.1097/SAP.0000000000004389. PMID: 40459465