Wrist Arthroscopy And TFCC Repair
What is wrist arthroscopy?
In severe cases of persistent pain or instability, surgical intervention may be required. This can be performed using an arthroscopic (keyhole) technique as a day case.
Two 4mm incisions are made at the back of the wrist, and a small telescope is inserted into the joint. The cartilage is examined under direct vision and the tear is identified. The torn cartilage is removed with a special shaver or heat probe. The 4mm incisions are then closed and some dressings are applied. The wrist is rested in a large bandage or plaster.
What is TFCC repair?
If the tear is extensive or involves the periphery of the TFCC, an open repair may be necessary. This is a more extensive surgery, but is only required when one of the main ligaments which stabilise the wrist has completely torn. It is usually clear prior to surgery whether there is a need for the more extensive procedure. In rare cases, the need for more extensive surgery is only identified during the time of the arthroscopic procedure. This is usually performed through a small incision on the back of the wrist and the ligaments are repaired with a strong stitch.
wrist arthroscopy recovery
If the tear has been removed with a shaver or heat probe, the wrist will be rested in a plaster splint for 2 weeks. The hand should be kept elevated in a sling (above the heart) for as long as possible during the first 5 days to prevent swelling.
The wrist will be painful after the surgery and pain relief should be taken regularly. Unless contraindicated, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be effective when taken with simple pain relief such as paracetamol. You will be seen in clinic after 2 weeks following the procedure. The splint and the sticky dressings will be removed and the wrist can start to be mobilised as far as the discomfort allows.
When can I return to work?
You can return to sedentary or office based work after 2 weeks, or when the pain allows. Manual work can be resumed after 6 weeks; however this is dependent on your profession. You may need to stay off work for longer if your duties involve repetitive movements that may aggravate the TFCC. You should speak with your consultant for clarification.
When can I drive again?
It is safe to drive after 2 weeks once the splint has been removed.
When can I return to sport?
You should wait at least 3 months before resuming any sports involving repetitive wrist movements including cricket, tennis and golf.
The One Team Specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
