Wrist arthroscopy Perth
Wrist
arthroscopy
Wrist arthroscopy is a type of keyhole surgery that helps diagnose and treat many wrist conditions and injuries. Using a tiny 1.9mm camera and fine instruments through a few small portals, we can look directly inside the joint. This means issues like ligament tears, damage to the triangular fibrocartilage complex (TFCC), or joint injuries can be diagnosed more accurately and often repaired at the same time.
For many people, wrist arthroscopy offers answers when scans and imaging haven’t been clear, along with the chance for treatment in a single procedure.
Why it’s used
The cause of wrist pain isn’t always easy to identify. Often injuries to the small wrist ligaments or bones do not show up on scans or imaging (like MRI, CT, ultrasound or X-ray). Arthroscopy enables us to look directly inside the wrist. For many people, that’s the first time the cause of their pain is found. In many cases the cause of the pain can be treated arthroscopically during
Who it helps
You might be offered wrist arthroscopy if you:
- Have a confirmed ligament tear, such as a TFCC or scapholunate injury.
- Have a fracture involving the wrist joint (for example scaphoid or distal radius) where precise repair is needed.
- Have wrist arthritis or cartilage wear that may benefit from debridement or smoothing.
- Have painful clicking, catching or swelling that hasn’t improved with therapy.
- Have loose bodies, cysts or a ganglion causing ongoing discomfort.
What exactly is wrist arthroscopy?
Wrist arthroscopy is a form of keyhole surgery used to both diagnose and treat wrist problems. Instead of making a large cut, the surgeon makes two or three very small cuts (called “portals”) around the wrist. A tiny camera, only 1.9mm wide, is inserted into the joint so the structures inside can be seen clearly on a screen.
Fine instruments can then be passed through the other portals to repair any damaged structures. Depending on what’s found, this might mean repairing a torn ligament such as the TFCC, smoothing rough cartilage, removing loose fragments, or helping to fix a fracture.
Is it the same as wrist replacement?
Conditions treated with wrist arthroscopy
Arthroscopy is a technique, not just one operation, and it’s used across a range of wrist problems. Common examples include:
TFCC tears and DRUJ instability
This technique was pioneered by our surgeons, and has been published and presented internationally. It is safe as it allows visualisation of the anatomical structures in the carpal canal (like small nerves). A small camera and instruments are inserted through a 2–3 cm incision in the wrist flexion crease. It allows your surgeon to see and release the tight ligament pressing on the nerve without performing a long cut in your palm. This can reduce scarring and speed up your return to daily activities. The incision is covered by small water-proof adhesive dressings. In most cases, both the right and left side can be performed at the same time, minimising time off work and disruption to your life.
Wrist ligament injuries
The most common is a scapholunate ligament tear, which can cause weakness, loss of motion and wrist pain. Arthroscopy allows both diagnosis and repair through small ‘keyhole’ portals, resulting in reduced scarring and quicker recovery time compared with open surgery.
Arthroscopic screw fixation allows the surgeon to repair the break with precision while also checking the wrist for other cartilage or ligament damage. In non-union cases, arthroscopic bone grafting can also be performed.
If the fracture involves the joint surface, your surgeon may use arthroscopy to align the surface fragments accurately, reducing the risk of stiffness or arthritis later.
Arthroscopy can smooth rough surfaces, remove loose fragments or treat focal cartilage defects. It can also be used to treat arthritis at the base of the thumb. Depending on the condition treated, this may result in reduced pain, improved range of motion and increased grip strength.
Small fragments of bone, ganglia and cysts inside the wrist can be treated arthroscopically, often with quicker recovery than open surgery.
What happens in wrist arthroscopy
In most cases, arthroscopy is a day procedure, although it does depend on the condition being treated. You may have local anaesthetic with sedation, or general anaesthetic if that’s more suitable.
Here’s what to expect:
- Two to four small cuts (or ‘portals’) are made in the wrist.
- A 1.9 mm arthroscope (or camera) is inserted, showing the joint in detail.
- Fluid may or may not be used, depending on the procedure.
- Fine instruments inserted through the portals are used to arthroscopically repair ligaments, smooth cartilage, remove debris or fix fractures.
- A removable splint may be fitted afterwards if a repair needs protection.
- You’ll usually see a hand therapist within a day or two to start gentle supervised movement.
Benefits and recovery
The main benefits are smaller incisions, less disruption to tissue, less scarring, greater diagnostic accuracy and the ability to diagnose and treat problems in the same procedure.
Recovery depends on the procedure being performed:
Diagnostic arthroscopy or debridement
light use within a few days; most people are back to desk work within a week.
TFCC or ligament repair
Splinting is required for 6 weeks. People usually return to restricted duties in 2-3 weeks and full unrestricted duties at 3-4 months. Early supervised gentle movement is encouraged with a hand therapist.
Splinting is required for 6 weeks. People usually return to restricted duties in 2-3 weeks and full unrestricted duties at 3-4 months. Early supervised movement is encouraged with a hand therapist.
Splinting is required for 6 weeks. People usually return to restricted duties in 2-3 weeks and full unrestricted duties at 3 months. An arthroscopic bone graft for a non-united scaphoid fracture is associated with a longer recovery period.
Risks of wrist arthroscopy
Every surgery has risks. With wrist arthroscopy, they include infection, bleeding, injury to nerves or tendons, stiffness, ongoing pain, or the need for more surgery later. There is also risk associated with anaesthesia. Your surgeon will explain these in detail before your procedure so you can make an informed decision.
Wrist surgeon Perth
Next steps
If you’ve been living with wrist pain that hasn’t been explained, or you’ve been told you may need a wrist arthroscopy, the first step is a thorough assessment. We’ll review your history, examine your wrist, and discuss your options. If arthroscopy is suitable, we’ll guide you through what to expect and how to prepare.
The Wrist + Hand Institute Perth operates at multiple hospitals including Bethesda Hospital (Claremont), Hollywood Hospital, St John of God Mt Lawley, South Perth Hospital and Sundew Day Surgery.
Frequently Asked Questions
What conditions can wrist arthroscopy help with?
It can be used for ligament tears (TFCC, scapholunate), scaphoid and distal radius fractures, scaphoid non-union, cartilage wear, arthritis, loose bodies and ganglia. It can also identify the cause of wrist pain that has not yet been diagnosed on imaging.