17 - Wrist and Hand Arthroscopy

Abstract

Wrist and hand arthroscopy are a relatively new technique and approach with under 35 years of clinical application and development. Nevertheless, in many clinical conditions, wrist arthroscopy in particular has opened up a new horizon for evaluation and treatment. During the past 20 years, numerous innovative techniques have been developed with specific surgical indications. More complex and precise new procedures can be performed with low complications. Therapeutic procedures are no longer restricted to resection process. More specific anatomic structure repairing procedures, and to the forefront, functional reconstruction procedures involving replenishment of tissue defect and augmentation of vital structures with graft material are seen with proven clinical value. The new therapeutic procedures are going to challenge the conventional ways and thinking of surgical treatment and long-term results are evolving. With the development of portal site local anesthesia (PSLA) to allow wrist arthroscopy to be performed under local anesthetic setting without tourniquet and sedation, the risk and cost associated with arthroscopy can markedly diminish and acceptance of the surgery both by the patients and the surgeons is escalated. One can foresee a much wider clinical application in the future and wrist and hand arthroscopy as an office diagnostic procedure becomes a real possibility.