Wrist arthroscopy
Wrist surgery; Arthroscopy - wrist; Surgery - wrist - arthroscopy; Surgery - wrist - arthroscopic; Carpal tunnel release
Wrist arthroscopy is surgery that uses a tiny camera and surgical tools to examine or repair the tissues inside or around your wrist. The camera is called an arthroscope. The procedure allows your surgeon to detect problems and make repairs to the wrist without making larger cuts in the skin and tissue. This means that you may have less pain and recover more quickly than open surgery.
Carpal tunnel syndrome is becoming more frequently recognized and may be occurring more often. It may result from repetitive motion or the use of devices like computer keyboards. It affects the median nerve, the nerve that supplies feeling and movement to the thumb and thumb-side of the hand.
Description
You may receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you will have regional anesthesia. This means your arm and wrist area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.
During the procedure, the surgeon does the following:
- Inserts the arthroscope into your wrist through a small incision. The scope is connected to a video monitor in the operating room. This allows the surgeon to view the inside of your wrist.
- Inspects all the tissues of your wrist. These tissues include cartilage, bones, tendons, and ligaments.
- Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage can be repaired. Any damaged tissue is removed.
At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.
Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a larger incision so that the surgeon can get directly to your bones and tissues.
Why the Procedure Is Performed
You might need wrist arthroscopy if you have one of these problems or procedures:
- Wrist pain. Arthroscopy allows the surgeon to explore what is causing your wrist pain.
- Ganglion removal. This is a small, fluid-filled sac that grows from the wrist joint. It is harmless, but it can be painful and can limit your ability to move your wrist freely.
- Ligament tears. A ligament is a band of tissue that connects bone to bone. Several ligaments in the wrist help keep it stable and allow it to move. Torn ligaments can be repaired with this type of surgery.
- Triangular fibrocartilage complex (TFCC) tear. The TFCC is a cartilage area in the wrist. Injury to the TFCC can cause pain on the outer aspect of the wrist. Arthroscopy can allow repairing damage of the TFCC.
- Carpal tunnel release. Carpal tunnel syndrome occurs when the nerve that passes through certain bones and tissues in your wrist becomes swollen and irritated. With arthroscopy the area through which this nerve passes can be made larger to relieve the pressure and pain.
- Wrist fractures. Arthroscopy can be used to remove small bits of bone and help realign the bones in your wrist.
- Arthritis. Arthroscopy can be used to remove tissues inside the arthritic joint and create more space.
Risks
Risks of anesthesia and surgery in general are:
- Allergic reactions to medicines
- Breathing problems
- Bleeding, blood clot, or infection
Risks of wrist arthroscopy are:
- Failure of surgery to relieve symptoms
- Failure of repair to heal
- Weakness of the wrist
- Injury to a tendon, blood vessel, or nerve
Before the Procedure
Tell your surgeon or nurse if:
- You are or could be pregnant.
- You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription.
- You have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
Planning for your surgery:
- If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your health care provider who treats you for these conditions.
- If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
- If needed, prepare your home to make it easier to recover after surgery.
- Ask your surgeon if you need to arrange to have someone drive you home after your surgery.
During the week before your surgery:
- You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
- Ask your surgeon which medicines you should still take on the day of surgery.
- Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.
On the day of surgery:
- Follow instructions about when to stop eating and drinking.
- Take the medicines your surgeon told you to take with a small sip of water.
- Arrive at the hospital on time.
After the Procedure
You can go home the same day after spending an hour or so in recovery. You should have someone drive you home.
Follow any discharge instructions you're given. These may include:
- Keep your wrist elevated above your heart for 2 to 3 days to help reduce swelling and pain. You can also apply a cold pack to help with swelling.
- Keep your bandage clean and dry. Follow instructions for how to change the dressing.
- You can take pain relievers, if needed, as long as your provider says it's safe to do so.
- You may need to wear a splint for 1 to 2 weeks or longer to keep the wrist stable as it heals.
- You may be instructed to exercise your fingers to avoid stiffness. Follow the instructions on how often you need to do the exercises.
Outlook (Prognosis)
Arthroscopy uses small cuts in the skin, so compared to open surgery, you may have:
- Less pain and stiffness during recovery
- Fewer complications
- Faster recovery
The small cuts will heal quickly and you may be able to resume your normal activities in a few days. But, if a lot of tissue in your wrist had to be repaired, it may take several weeks to heal.
You may be shown how to do gentle exercises with your fingers and hand. Your provider may also recommend that you see a hand therapist to help you regain the full use of your wrist.
References
Geissler WB, Rush DA, Keen CA. Wrist arthroscopy. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 69.
Weller WJ. Wrist disorders. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 69.
Version Info
Last reviewed on: 6/4/2025
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
