Minimal invasions: is wrist arthroscopy supported by evidence? A systematic review and meta-analysis


  • Venla-Linnea Karjalainen Central Finland Health Care District
  • Ian A Harris Ingham Institute for Applied Medical Research, South West-ern Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia
  • Mikko Räisänen Department of Orthopae-dics and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
  • Teemu Karjalainen Department of Surgery, Hospital Nova of Central Finland, Jyvaskyla, Finland and Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Malvern, Australia





Background and purpose: Wrist arthroscopy is used increasingly, but its benefits and harms are unclear. This systematic review aimed to identify all published randomized controlled trials on wrist arthroscopy and synthesize the evidence of the benefits and harms of wrist arthroscopic procedures.
Methods: We searched CENTRAL, MEDLINE, and Embase for randomized controlled trials comparing wrist-arthroscopic surgery with corresponding open surgery, placebo surgery, a non-surgical treatment, or no treatment. We estimated the treatment effect with a random effect meta-analysis using patient reported outcome measure (PROM) as primary outcome where several studies assessed the same intervention.
Results: Of 7 included studies, none compared wrist arthroscopic procedures with no treatment or placebo surgery. 3 trials compared arthroscopically assisted reduction with fluoroscopic reduction of intra-articular distal radius fractures. The certainty of evidence was low to very low for all comparisons. The benefit of arthroscopy was clinically unimportant (smaller than what patients may consider meaningful) at all time points. 2 studies compared arthroscopic and open resection of wrist ganglia, finding no significant difference in recurrence rates. 1 study estimated the benefit of arthroscopic joint debridement and irrigation in intra-articular distal radius fractures, showing no clinically relevant benefit. 1 study compared arthroscopic triangular fibrocartilage complex repair with splinting in distal radioulnar joint instability in people with distal radius fractures, finding no evidence of benefits for repair at the long-term follow-up but the study was unblinded, and the estimates imprecise.
Conclusion: The current limited evidence from RCTs does not support benefits of wrist arthroscopy compared with open or non-surgical interventions.


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How to Cite

Karjalainen, V.-L., Harris, I. A., Räisänen, M., & Karjalainen, T. (2023). Minimal invasions: is wrist arthroscopy supported by evidence? A systematic review and meta-analysis. Acta Orthopaedica, 94, 200–206.