surgery, treatment, and post-operative care
Wrist arthroscopy, also known as keyhole surgery or wrist scope, is a surgical procedure used to allow your surgeon a bird’s eye view of your wrist, helping to diagnose and treat specific wrist and hand problems accurately.
This procedure will be carried out if you are experiencing problems with your wrist, such as cartilage damage/tears, injuries to ligaments, arthritis, and more, providing a much more in-depth investigation and detailed picture of your wrist.
Serving two primary purposes, wrist arthroscopy ultimately:
1. Allows us to inspect inside a patient’s wrist thoroughly and accurately, by making a small incision in the back of the wrist where a thin telescope is then inserted.
2. Depending on the investigation, treatment can often be carried out there and then, with repairs carried out during the exploration surgery.
Treating your wrist problems
There are many varying reasons why you may experience wrist problems. For example, if you have fallen or twisted your wrist, or you’re experiencing pain, swelling, or clicking in your wrist and fingers.
All of these problems can indicate an underlying problem that needs treatment.
In these instances, wrist arthroscopy can be used to diagnose and repair:
- Cartilage damage
- Ganglion cysts
- Joint infections
- Inflammation – caused by rheumatoid arthritis
All in a day…
A day procedure, arthroscopy surgery itself will be carried out under general anaesthetic, with the procedure taking between 30minutes to an hour depending on the outcome of the initial visual investigation.
You will be awake during the procedure, and full care and attention will be provided to ensure that you’re completely at ease throughout.
In some cases, treatment can be performed there and then by inserting miniature instruments into the second incision made in the wrist, repairing and removing any damaged tissue that is found.
The main instrument used throughout this procedure is an arthroscope.
An arthroscope contains a collection of optical fibres which are used collectively to illuminate and highlight the inner workings of your wrist joint. Relaying real-time images of the inside of your wrist to the screen for your surgical team to see, and make the most informed decisions from.
The surgery itself, as mentioned, will consist of making two tiny incisions and cutting into the back of your wrist.
The first incision will be used to carry out the investigation of your wrist using the arthroscope (inserting a small camera into your wrist so your surgeon can investigate, diagnose, and treat your wrist injury or condition). The second incision is used for other surgical instruments which help identify and treat any problems identified at the time of surgery.
Keyhole surgery like arthroscopy often means patients recover quicker than from other forms of invasive hand surgery.
Benefits of Arthroscopy Procedures
There are several benefits to arthroscopy, with the main one being that any pain and swelling in your hand and wrist can be profoundly reduced.
Other benefits of arthroscopy include:
- Most injuries found during stage one of the procedure can be diagnosed and treated during the same operation, so you don’t have to return for the second round of surgery
- Small incisions and tools are used rather than extensive open hand surgery
- Keyhole surgery like this poses fewer complications and risks compared to open surgery procedures
- Patients report less pain and joint stiffness after wrist arthroscopy, proving it to be an extremely successful procedure
- Keyhole surgery offers you quicker recovery time.
Recovery time is typically six weeks. However, this does vary and is dependent on what repairs and treatment have been carried out during surgery. For example, repairs to damaged tissue will make recovery time longer. However, your surgeon will provide full information and post-operative care guides tailored to you and your operation.
After surgery, your wrist and the surrounding area will be bruised, and this is completely normal. The area will also be tender and swollen, and we can, and do, recommend painkillers and ice to help.
Bruising and swelling do vary from patient to patient, and it is not uncommon for this to last up to 3 weeks after surgery.
Your surgeon and care team will work with you and advise on activities and physiotherapy after surgery to keep your wrist and fingers moving and swelling to a minimum.
Immediately after surgery, we recommend that you limit your activities until strength and movement return to normal. Keeping your hand and wrist elevated as much as possible for the first few days after surgery, with any sutures being removed on your follow up appointment typically 10 to 14 days after surgery.
Most patients find that they’re able to resume normal activities after a couple of weeks, with movement improving and pain easing over time.
When it comes to driving, we would advise you to wait at least 7 days before getting back behind the wheel. This is to allow the wrist to heal properly, providing you with a better grip of the steering wheel and gear stick.
The best time to return to work will depend on the individual, and the type of work environment patients operate in. Time off after surgery should be considered, as well as light duties until you feel your wrist and hand has regained full strength.
What does wrist arthroscopy treat?
This exploration surgery is ultimately designed to discover and treat damaged tissue in the wrist and hand.
Some of the main wrist complaints this type of specific surgery can help treat include:
- Cartilage damage. A tear in the cartilage of the wrist joint is not uncommon, where the triangular fibrocartilage (the `cushion` between the bones of the wrist joint) becomes damaged through injury or general wear and tear. Arthroscopy can help identify where the problem is, and depending on the severity, it is possible to treat slight tears by trimming or removing loose cartilage while surgery is being carried out.
- Arthritis/Synovitis. We understand how painful arthritis in the wrist can be, and in some cases, by repairing or removing the damaged and often inflamed tissue on the joint surfaces, pain can be alleviated. Through this keyhole surgery technique, we can also look to trim and tidy up bone spurs helping to improve wrist mobility considerably.
- Ulnar-impaction syndrome. Removing a small amount of bone and cartilage (enough to stop it from impacting on the wrist), allows us to treat ulnar-impaction syndrome through keyhole surgery. Often referred to as the “wafer procedure” as the piece of bone removes is wafer-thin.
- Carpal instability. Using scans alone is sometimes not enough to truly diagnose the extent of a wrist injury, especially injuries involving ligament tears. Wrist arthroscopy helps to provide the in-depth analysis required to confirm the type and extent of the damage, as well as providing suitable treatment options.
Overall, arthroscopy aims to confirm, with a high degree of accuracy, your wrist complaint, and in most cases, provide positive treatment during the same surgery.
Make your appointment today
Arranging an appointment with our specialist hand surgeons allows us to diagnose your symptoms fully and for you to have your questions answered.
In this initial discussion, we will talk you through the arthroscopy procedure as well as treatment options suitable and tailored to you and your condition.
Using the latest technology, we ensure you receive the very best hand and wrist care, always.
Book your appointment with the Manchester Hand Surgeon today.
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