Recent advances and future trends in wrist arthroscopy

Abstract

For a long time, wrist arthroscopy has languished behind that of shoulder and elbow arthroscopy. However, over the past two decades, there has been a steady increase in therapeutic wrist procedures undertaken using the arthroscope. While diagnostic wrist arthroscopy is still a useful tool, its therapeutic advantages are starting to stack up against the risks of open wrist surgery – mainly stiffness. It remains a technically demanding procedure, but is clearly in the armamentarium of orthopedic hand and wrist surgeons. Recent advances of dry arthroscopy, arthroscopic reduction and internal fixation, and arthroscopic fusion procedures have changed the face of minimally invasive wrist surgery. The new NanoScope™ along with wide-awake, local anesthetic, and no tourniquet techniques, means that we now can dynamically assess and treat wrist pathology without even encountering the risk of anesthesia. Wrist surgery is evolving, and arthroscopy is right at the forefront.

Bare bones: Fundamentals of diagnostic wrist arthroscopy

“…8,9 The use of local anaesthetic techniques, including WALANT (Wide Awake Local Anaesthesia No Tourniquet), whilst requiring a compliant patient, has the advantage of allowing for active dynamic assessment of the wrist throughout the procedure, which is particularly useful when assessing for carpal instability 10 or testing the integrity of the TFCC, 11 in addition to reducing the logistical burden of arthroscopy under general anaesthesia. 12 Once adequate anaesthesia has been achieved, clinical examination of the wrist should be performed for any mechanical instability that may have previously been too uncomfortable for the patient, and/or masked by guarding. Following this, the patient is positioned for the arthroscopic procedure (Fig.…”

The Current Role of Arthroscopy in Traumatic Wrist Injuries: An Expert Survey

“…Following arthroscopy of the knee, shoulder, and elbow, arthroscopy of the wrist was introduced primarily as a diagnostic tool in the mid-1980s. 1 Over recent years, the procedure has become increasingly popular among hand and wrist surgeons for the diagnosis and treatment of traumatic wrist injuries and has found its way to the standard medical care.…”