The role of arthroscopy in arthritis. "Ectomy" procedures

Advances in arthroscopic techniques and instrumentation have enabled the surgeon to extend the therapeutic possibilities of wrist arthroscopy. The introduction of suction punches and smaller, lighter motorized resectors and burrs have facilitated the arthroscopic removal of bone and soft tissue. Arthroscopy provides the surgeon with a magnified view of all intra-articular structures, including those areas difficult to access via an arthrotomy. With the new instrumentation and the excellent views, bone and soft tissues can be resected with precision. Now the wrist arthroscopist can effectively perform a synovectomy; debride a torn TFC, chondral defects, and osteoarthritis; remove loose bodies; and resect the distal ulna and carpal bones. The surgeon should follow the anatomic principles that have been developed for open surgical procedures. Arthroscopic surgery is minimally invasive, hence patients rehabilitate quickly with fewer complications. "Ectomy" surgery of the wrist requires a higher level of skill from the surgeon but, when mastered, provided considerable benefit to the patient.