29846 Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement

Name of the Procedure:

Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement

Summary

Arthroscopy of the wrist is a minimally invasive surgical procedure where a small camera (arthroscope) is inserted into the wrist joint. This procedure involves the excision (removal) and/or repair of the triangular fibrocartilage complex (TFCC) and may also include cleaning out the joint (debridement) to remove loose fragments and damaged tissue.

Purpose

This procedure addresses issues related to the triangular fibrocartilage complex (TFCC) and other joint abnormalities. The primary goals are to alleviate pain, improve joint function, and restore the normal range of motion by repairing or removing damaged tissue.

Indications

• Persistent wrist pain
• TFCC tears or injuries
• Wrist instability
• Limited wrist movement
• Swelling or inflammation of the wrist joint
• Degenerative joint diseases

Preparation

• Patients may need to fast for 6-12 hours before the procedure.
• Stop taking certain medications, especially blood thinners, as advised by your physician.
• Undergo pre-operative diagnostic tests such as X-rays or MRI scans to assess the condition of the wrist.

Procedure Description

1. The patient is typically given regional or general anesthesia.
2. Small incisions are made around the wrist joint.
3. An arthroscope (a thin, flexible tube with a camera) and surgical instruments are inserted through the incisions.
4. The surgeon repairs or removes damaged tissue within the TFCC and performs joint debridement if necessary.
5. The instruments are removed, and the incisions are closed with sutures or staples.
6. A sterile bandage is applied, and the wrist is usually immobilized with a splint.

Duration

The procedure typically takes 1-2 hours, depending on the extent of the repair needed.

Setting

The procedure is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon or a hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Stiffness or reduced range of motion
• Persistent pain or symptoms
• Complications related to anesthesia

Benefits

• Relief from pain and discomfort
• Improved wrist function and range of motion
• Reduced inflammation and swelling
• Faster recovery compared to open surgery

Recovery

• Post-procedure, the wrist may be immobilized in a splint or cast for several weeks.
• Pain management with prescribed medications.
• Physical therapy may be recommended to restore movement and strength.
• Full recovery can take several weeks to months, depending on the extent of the surgery and individual healing rates.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Non-surgical treatments such as physical therapy, orthotics, and anti-inflammatory medications.
• Corticosteroid injections to reduce inflammation and pain.
• Open wrist surgery, though it typically involves a longer recovery period and more invasive approach.

Patient Experience

Patients may feel discomfort or moderate pain post-surgery, which can be managed with pain medications. Swelling and limited wrist movement are common initially. Physical therapy will help restore function, and most patients can expect a significant improvement in symptoms within weeks to months.