Arthroscopic Equipment and Set Up for Wrist Arthroscopy

Abstract

Wrist arthroscopy is the golden standard of diagnosing wrist disorders and used as a tool for the treatment of various pathologies. The first case was performed by M.S. Burman in 1931 and at that time no future role for arthroscopic treatment of wrist pathologies was anticipated [1]. Later, in 1971, M. Watanabe in Japan reported his first experience after 19 arthroscopies of the radiocarpal joint with a 1.7-mm diameter arthroscope due to the development of thinner arthroscopes and better light sources [2]. Thereafter, wrist arthros-copy quickly gained popularity during the 1980s and 1990s, when Terry Wipple in America and Hempfling in Germany started to pioneer more modern techniques [3,4]. Since then, arthroscopy of the radiocarpal, midcarpal and distal radioulnar joint has been used with increasing frequency for pathology in the wrist, establishing the gold standard for assessing and managing intra-articular joint-related pathology of the wrist joint.Arthroscopy of the wrist is a challenging procedure due to smaller dimensions of joint spaces and a higher risk of damage to important structures. Wrist arthroscopy includes the radiocarpal joint, the midcarpal joints and may include the distal radioulnar joint. The midcarpal joint should be inspected as a routine during wrist arthroscopy. The distal radioulnar may be assessed depending on patient presentation.Historically, the complication rate of wrist arthroscopies is low, which has been described at up to 2% of cases. However, recent studies indicate a higher risk with up to 5.98% complication rate [5,6]. Most frequently the failure to achieve functional improvement (1.16%) and nerve lesions has been reported. Other complications are injuries to tendons, arteries, tendon fistulas, carpal tunnel syndrome, compartment syndrome, stiffness, infection, cartilage lesions and complex regional pain syndrome and cysts. Another important factor is the experience of the surgeon; the risk of a complication decreases with the R. S.