Wrist Arthroscopy

Arthroscopy is a valuable test for evaluating the wrist joint. It is used mostly for diagnosis (finding a problem). Arthroscopy is a surgical technique that uses small incisions (cut made by the surgeon) to insert a small telescope-like instrument (arthroscope) and other tools into the joint. This allows the surgeon to look directly at the problem. The arthroscope then beams light into the joint and sends an image to a screen. As your surgeon examines your wrist, he or she can also repair a number of problems found at the same time. Sometimes the surgery may have to be changed to an open surgery if the problems are too severe. This is usually a very safe surgery. Possible complications include: damage to nerves or blood vessels, excess bleeding, blood clots, the possibility of infection, and rarely instrument failure. This is most often performed as a same day surgery. This means you will not have to stay in the hospital overnight. Recovery from this surgery is also much faster than having an open procedure.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies.

  • Medications taken including herbs, eye drops, over-the-counter medications, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • Possibility of pregnancy, if this applies

  • History of blood clots (thrombophlebitis).

  • History of bleeding or blood problems.

  • Previous surgery.

  • Other health problems.

BEFORE THE PROCEDURE

  • Stop all anti-inflammatory medications at least 1 week prior to surgery unless instructed otherwise. Make sure to let your surgeon know if you have been taking cortisone.

  • Do not eat or drink after midnight or as instructed. Take medications as your caregiver instructs. You may have lab tests the morning of surgery.

  • You should be present 60 minutes prior to your procedure or as directed.

PROCEDURE

You may have a general anesthetic. This is medication that makes you sleepy during the procedure. You may have a local anesthetic in which just the part being worked on is numb. Your surgeon, anesthesiologist, or anesthetist will discuss this with you. Some of the most commonly encountered problems in the wrist joint area are ligament tears and damage to the cartilage. Ligamentous tears may have to be repaired with an open procedure. Cartilage tears may be shaved off or loose pieces of cartilage removed.

AFTER THE PROCEDURE

  • After surgery, you will be taken to the recovery area where a nurse will watch and check your progress. Once you are awake, stable, and taking fluids well, barring other problems you will be allowed to go home.

  • Once home, an ice pack applied to your operative site for 20 minutes, 3 to 4 times per day, for 2 to 3 days, may help with discomfort and keep the swelling down.

  • Use medications as prescribed.

  • Do range of motion exercises with wrist as directed.

  • Keep your wrist elevated and wrapped to keep swelling down and to decrease pain. This also speeds healing.

REHABILITATION

  • Wrists are often swollen, stiff, and painful following surgery. The recovery time will vary with the procedure done, damage repaired, and the general health and age of the patient. Splints, casts, or bandages will be worn for various amounts of time.

  • If physical therapy and exercises are prescribed by your surgeon, follow them carefully.

  • Avoid gripping or lifting heavy objects.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is redness, swelling, or increasing pain in the wound or joint.

  • You notice purulent drainage (pus) coming from the wound.

  • An unexplained oral temperature above 102° F (38.9° C) develops.

  • You notice a foul smell coming from the wound or dressing.

  • There is a breaking open of the wound (edges not staying together) after sutures or tape has been removed.