Wrist Arthroscopy
Wrist arthroscopy is a major part of Dr Ye’s practice. He regularly sees patients with complex wrist problems, including second opinions, tertiary referrals and revision cases.
The wrist is one of the most complex joints in the body. It contains multiple small bones, ligaments, joint surfaces and cartilage surfaces that all need to work together. Many important parts of the wrist are difficult to see or treat through traditional open approaches without disturbing normal soft tissues.
Wrist arthroscopy allows the joint to be assessed from the inside using small keyhole incisions. This provides a detailed view of the cartilage, ligaments, joint surfaces and patterns of instability. It also allows the surgeon to reach parts of the wrist that are otherwise difficult to access.
Why Wrist Arthroscopy?
The main advantage of wrist arthroscopy is not simply that the incisions are smaller. It is that arthroscopy allows a more selective and individualised approach to wrist problems.
Rather than opening the wrist widely and treating different injuries in a more general way, arthroscopy allows Dr Ye to identify the exact structures that are injured and treat them specifically. This may include cartilage injuries, ligament tears, joint inflammation, instability, loose bodies, fracture fragments or areas of arthritis.
In many cases, arthroscopy allows treatment to be targeted to the patient’s particular pattern of injury. It can preserve normal soft tissues, protect important ligaments and capsules, and avoid unnecessary disruption to parts of the wrist that are still functioning well.
This is particularly important in ligament injuries, where the surrounding capsule and extrinsic ligaments are crucial stabilisers of the wrist. Arthroscopy allows a more detailed understanding of which stabilisers are injured and which remain intact. This can help guide a more precise reconstruction or repair.
Conditions Treated with Wrist Arthroscopy
Dr Ye offers a broad range of wrist arthroscopy procedures, including:
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wrist ganglion removal
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TFCC repair and reconstruction
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scapholunate ligament stabilisation
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arthroscopic bone grafting and fixation of scaphoid non-union
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arthroscopic assessment and treatment of cartilage injuries
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arthroscopic treatment of wrist arthritis
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arthroscopic assistance for distal radius fractures
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arthroscopic assessment in malunion, osteotomy and revision surgery
Arthroscopy can also be combined with open surgery in complex cases. In these situations, it may be used to assess the joint, guide reduction, treat associated ligament injuries or improve the precision of reconstruction.
Arthroscopic Scaphoid Non-union Bone Grafting
A particular area of interest in Dr Ye’s practice is arthroscopic bone grafting and fixation for scaphoid non-union.
Traditionally, scaphoid non-unions were treated through open surgery. In selected patients, arthroscopic treatment can allow bone grafting and screw fixation through small incisions while preserving the blood supply and soft tissues around the scaphoid.
This approach has changed the way many scaphoid non-unions can be treated. By accessing the non-union in a minimally invasive way and protecting the biology of the bone, union rates in appropriately selected patients are high and often exceed 90%.
Scapholunate Ligament Injuries
Scapholunate ligament injuries are among the most challenging wrist injuries to treat. They can cause pain, clicking, weakness and progressive wrist instability. Historically, many different operations have been used, with variable results.
Contemporary wrist arthroscopy allows a more detailed understanding of scapholunate instability. It helps identify which parts of the ligament complex are injured, whether the injury is repairable, and how much the surrounding stabilising structures are contributing to the problem.
This allows treatment to be more specific to the pattern of instability. In some patients, arthroscopic repair or stabilisation may be appropriate. In others, arthroscopy may be combined with open reconstruction, capsulodesis, fixation or osteotomy. The aim is to stabilise the wrist while preserving as much normal motion and soft tissue function as possible.
TFCC Injuries and Ulnar-sided Wrist Pain
TFCC injuries are a common cause of pain on the ulnar side of the wrist. Patients may experience pain with gripping, twisting, lifting, pushing up from a chair or loading the wrist in sport or work.
Wrist arthroscopy allows the TFCC to be assessed directly. This is important because not all TFCC tears are the same. Some are stable and may only require debridement. Others are unstable and require repair. Some are associated with distal radioulnar joint instability or ulnar impaction and may need to be combined with other procedures such as an ulnar shortening osteotomy.
Dr Ye commonly treats TFCC injuries arthroscopically, either as an isolated procedure or as part of a broader reconstruction when needed.
Wrist Arthritis, Fractures and Revision Surgery
Wrist arthroscopy can also be useful in selected cases of wrist arthritis, distal radius fractures, malunions and revision surgery.
In arthritis, arthroscopy can help assess the pattern of cartilage loss, remove inflamed tissue, treat impinging areas and guide decisions about joint-preserving procedures. In fractures and malunions, arthroscopy can assist with assessing the joint surface, reducing small fragments and identifying associated ligament injuries.
In revision surgery, arthroscopy can be particularly valuable because it allows the joint to be assessed directly with less additional soft tissue disruption. This can help clarify the cause of persistent pain, stiffness, instability or mechanical symptoms after previous treatment.
Training and Experience
Dr Ye has undertaken fellowship training with a strong focus on wrist arthroscopy and complex wrist reconstruction. He has also travelled internationally to visit leading wrist arthroscopy centres, including the Institut de la Main in Paris and Dr Francisco del Piñal’s unit in Madrid, to further refine his understanding of contemporary arthroscopic and reconstructive techniques.
Dr Ye treats both paediatric and adult wrist conditions, including sports injuries, fractures, ligament injuries, instability, non-union, arthritis and complex post-traumatic problems.
While arthroscopy is a major part of his practice, Dr Ye is also experienced in contemporary open techniques for wrist instability, fracture reconstruction, osteotomy, revision surgery and joint replacement. The best treatment is not always arthroscopic. Dr Ye will discuss the full range of options depending on the diagnosis, goals and expected recovery.
Dr Ye is happy to see patients for second opinions or revision wrist problems, particularly where the diagnosis is unclear, symptoms have persisted despite treatment, or previous surgery has not achieved the desired outcome.