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Medical Monday: What is a wrist arthroscopy and why do I need one?

Posted at 7:08 PM, Jan 16, 2017
and last updated 2017-01-16 20:09:53-05
Dr. Klika is a hand and upper extremity fellowship trained orthopedic surgeon with BayCare Clinic and joined us on Wisconsin Tonight. 
 
A wrist arthroscopy is a minimally invasive surgery used to treat or diagnose soft tissue wrist problems. A tiny camera called an arthroscope is used to examine and/or repair tissues inside or around the wrist. This helps the orthopedic surgeon identify problem areas and make repairs to the wrist without making larger incisions in the skin and tissue. This means the patient typically has less pain and a faster recovery than with open surgery. Depending on the diagnosis, a typical wrist arthroscopy takes 45 minutes to an hour to be completed.
 
A person might need wrist arthroscopy if they’ve experienced a wrist injury and have tried conservative solutions such as splinting, injection with cortisone and physical therapy, and still have persistent pain in their wrist weeks or months down the line. Arthroscopy allows the orthopedic surgeon to explore what is causing the wrist pain. It is often used both for diagnostic and therapeutic purposes; it remains the gold standard for diagnosing ligament injuries as it is more accurate than MRI. Primary reasons why someone might need a wrist arthroscopy include:
 
* Ligament tears: Torn ligaments can be repaired with this type of surgery.
 
* Carpal tunnel release: Carpal tunnel syndrome occurs when the median nerve that traverses the wrist becomes swollen and irritated from compression. A scope can be placed beneath the carpal tunnel ligament to allow ligamentous release which can help relieve the pressure, pain and numbness complaints.
 
* Wrist fractures: Arthroscopy can be used to help align the articular surface of the wrist as well as remove loose bodies in chronic injuries.
 
* Wrist infection: With a septic wrist where an infection involves the wrist joint and won’t respond to antibiotics alone, an irrigation procedure for infection eradication can be carried out with an arthroscopic approach rather than open incisional approach.
 
* Ganglion cyst removal: This is a small, fluid-filled sac that grows from the wrist joint. It’s harmless, but it can be painful and can limit your ability to freely move the wrist.
 
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 procedure is done in an outpatient setting and most patients go home the same day. The recovery period is dependent on the injury severity and type of repair required, but the orthopedic surgeon will determine the recovery timeline that’s best for you (i.e. longer healing period in cases of ligament repairs). Therapy may be added postoperatively to optimize wrist range of motion, strength and function recovery.
 
The risks and complications of a wrist arthroscopy include:
 
* Infection
* Bleeding
* Excessive swelling
* Nerve injuries
* Stiffness
* Scarring and tendon tearing
 
However, an experienced surgeon specialized in wrist arthroscopy can reduce the likelihood of complications.
 
For more information, visit baycare.net or call 877-229-2273.