Wrist Arthroscopy

Dr Jacqueline Tan

Senior Consultant Hand Surgeon

MBBS (SG) | MRCS (Edin) | MMed (Surgery) | FAMS (Hand Surgery)

Wrist arthroscopy is a minimally invasive surgical procedure that uses a small camera (arthroscope) inserted through small incisions to examine and treat conditions affecting the wrist joint. The arthroscope displays detailed images on a screen, allowing surgeons to diagnose issues and perform repairs with precision while causing minimal trauma to surrounding tissues.

Indications Benefits Preparation Procedure Recovery Risks FAQ

Indications for Wrist Arthroscopy

Wrist arthroscopy may be recommended for specific conditions when symptoms persist despite prior treatments.

Chronic Wrist Pain: Pain persisting despite conservative treatment requires direct visualisation of joint structures to identify the underlying cause.
Ligament Tears: Scapholunate and triangular fibrocartilage complex (TFCC) injuries can be accurately diagnosed and repaired through arthroscopy.
Cartilage Damage: Arthroscopy allows evaluation and treatment of damaged cartilage surfaces within the joint.
Ganglion Cysts: These fluid-filled lumps can be removed through small incisions using arthroscopic techniques.
Wrist Fractures: Some fractures benefit from arthroscopic assessment and repair, particularly those involving the joint surface.

Benefits of Wrist Arthroscopy

Wrist arthroscopy provides several benefits over traditional open surgery, including:

Minimal Scarring: The use of small incisions results in less noticeable scarring and minimal tissue damage.
Faster Recovery: Patients often experience shorter healing times and can return to daily activities more quickly than with open surgery.
Accurate Diagnosis: Direct visualisation of the joint enables precise identification of issues that may not appear on imaging studies.
Lower Risk of Infection: The minimally invasive approach reduces tissue disruption, lowering the chances of post-operative infections.

Surgery Preparation

Medical Evaluation

A comprehensive evaluation includes a physical examination, medical history review, and imaging studies such as X-rays, MRIs, or CT scans to assess wrist conditions. Blood tests check overall health and identify any factors that may affect surgery or recovery.

Medication Adjustments

Certain medications, particularly blood thinners, may need modification or temporary cessation. Provide a complete list of current medications to your surgeon, including supplements and over-the-counter drugs.

Fasting Guidelines

Avoid all food and drink for at least 8 hours before surgery. Approved medications may be taken with a small sip of water if instructed by your surgeon.

Step-by-Step Procedure

Anaesthesia Administration

Regional or general anaesthesia is administered based on individual factors and surgical requirements. The surgeon monitors vital signs throughout the procedure.

Portal Placement

Small incisions (portals) are made around the wrist. Their precise location depends on the area requiring treatment. Fluid is injected to expand the joint space for better access and visibility.

Joint Examination

The arthroscope enters through one portal while specialised instruments access the joint through others. The surgeon systematically examines all joint structures.

Repair Procedure

Specific repairs are performed based on identified problems. This may include removing damaged tissue, repairing tears, or addressing bone issues.

Incision Closure

The incisions are closed with small sutures. A sterile dressing and compression bandage are applied to protect the surgical site.

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Post-Surgical Care and Recovery

Immediate Care

Elevate the wrist above heart level for the first few days to minimise swelling. Apply ice packs as recommended and follow the prescribed regimen for pain medication and antibiotics.

Recovery Process

A splint or brace supports the wrist for 1–2 weeks. Gentle range-of-motion exercises are introduced after initial healing, progressing to strengthening exercises under the guidance of a physiotherapist.

Follow-up Care

Regular follow-up appointments ensure proper healing. Sutures are typically removed after 10–14 days, and most patients gradually resume normal activities within 4–6 weeks.

Potential Risks and Complications

While wrist arthroscopy is generally safe, it carries potential risks, including infection, bleeding, and nerve injury. Temporary stiffness or weakness may occur in some patients. In complex cases, conversion to open surgery might be necessary. Anaesthesia-related complications are possible, and in rare instances, patients may experience chronic pain or incomplete resolution of symptoms.

Frequently Asked Questions

Can wrist arthroscopy address arthritis?

Wrist arthroscopy can effectively manage arthritis symptoms by removing loose cartilage fragments, smoothing damaged joint surfaces, and addressing inflammation. However, it may not fully resolve symptoms in cases of advanced arthritis, where more extensive treatments may be necessary.

Will I need physiotherapy?

Most patients benefit from physiotherapy to restore strength and flexibility. Your surgeon designs a specific rehabilitation programme based on the procedure performed and your individual needs.

How soon can I resume sports or heavy lifting?

The timeline for returning to sports or heavy lifting typically ranges from 6–12 weeks after surgery. The exact duration depends on your healing progress, the specific procedure performed, and the outcomes of physiotherapy.

Dr Jacqueline Tan

Senior Consultant Hand Surgeon

MBBS (SG)

MRCS (Edin)

MMed (Surgery)

FAMS (Hand Surgery)

Dr. Jacqueline Tan is a hand surgeon in Singapore with over 18 years of experience in managing hand, wrist, and nerve conditions. Formerly the Head of Department of Hand and Reconstructive Microsurgery at Singapore General Hospital, she has continued to contribute significantly to her profession.

Director of Micro-Reconstruction Service and the Director of Peripheral Nerve and Paralytic Upper Limb Service
Upon the completion of her training as a hand surgeon in Singapore, Dr Tan was awarded the prestigious Health Manpower Development Plan scholarship by the Ministry of Health (MOH).
Completed a one-year advanced fellowship in Taiwan under the tutelage of internationally-acclaimed Hand and Orthopedic Microsurgeon – Professor Yuan-Kun Tu
Dr Tan’s field of expertise is in early and late brachial plexus reconstruction, peripheral nerve disorders, reconstructive microsurgery of the extremities and wrist disorders.

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