Arthroscopy, wrist, surgical; synovectomy, partial
CPT4 code
Name of the Procedure:
Arthroscopy, wrist, surgical; synovectomy, partial
Common Names: Wrist Arthroscopy for Synovectomy, Partial Synovectomy of the Wrist
Summary
Arthroscopy of the wrist with partial synovectomy is a minimally invasive surgical procedure where a small camera (arthroscope) and surgical instruments are inserted into the wrist joint to remove part of the inflamed synovial tissue.
Purpose
This procedure aims to relieve pain, reduce inflammation, and improve wrist function by removing diseased synovial tissue. It addresses conditions like chronic synovitis, rheumatoid arthritis, or persistent wrist pain not relieved by conservative treatments.
Indications
- Chronic wrist pain due to synovitis
- Rheumatoid arthritis with synovial inflammation
- Persistent wrist swelling and tenderness
- Limited wrist motion unresponsive to medication or physical therapy
Preparation
- Fasting for at least 6-8 hours before surgery
- Adjustments to medications (e.g., blood thinners)
- Preoperative imaging studies such as X-rays or MRI
- Blood tests to assess general health
Procedure Description
- Administer anesthesia (local, regional, or general).
- Create small incisions (portals) around the wrist.
- Insert the arthroscope to visualize the joint.
- Introduce surgical instruments through additional portals.
- Remove inflamed synovial tissue partially and thoroughly irrigate the joint.
- Close the incisions with sutures or adhesive strips and bandage the wrist.
Duration
Typically lasts 60-90 minutes.
Setting
Performed in a hospital, outpatient clinic, or surgical center.
Personnel
- Orthopedic Surgeon or hand specialist
- Surgical nurse
- Anesthesiologist or nurse anesthetist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Nerve or blood vessel damage
- Stiffness or reduced wrist motion
- Recurrence of symptoms
- Adverse reactions to anesthesia
Benefits
- Relief from chronic pain and inflammation
- Improved wrist function and range of motion
- Minimally invasive with smaller incisions leading to faster recovery
- Lower risk of complications compared to open surgery
Recovery
- Keep the wrist elevated and apply ice to reduce swelling.
- Follow prescribed physical therapy and exercises to regain motion.
- Use a splint or brace if recommended.
- Avoid heavy lifting and strenuous activities for several weeks.
- Follow-up appointments for suture removal and progress assessment.
Alternatives
- Conservative treatments: medications, physical therapy, corticosteroid injections
- Open synovectomy (more invasive with a longer recovery)
- Wrist joint replacement or fusion for severe cases
Patient Experience
During the procedure, patients under general anesthesia will not feel pain. If regional or local anesthesia is used, mild discomfort may be felt. Post-procedure, patients might experience soreness, mild pain, and swelling. Pain is managed with prescribed medications, and most discomfort subsides within a few days. Full recovery and return to normal activities usually occur within 4-6 weeks, with physical therapy aiding in regaining strength and mobility.