Like a Rubik's Cube, the wrist is complex. We take the elaborately elegant joint for granted, unless it's not working.

      Take the ache Mark Bouchard experienced in his right wrist. It felt like two bones hitting against each other. Add to that, swelling and soreness.

"I went to my doctor and he recommended I receive therapy," Bouchard said through an interpreter. "But after a few sessions, the therapist thought I might need surgery because there was a lot of 'noise' in my wrist." After an MRI, Bouchard's doctor, Robert Hendrikson, MD, an orthopaedic surgeon with the Orthopaedic Center at Waterbury Hospital, proposed wrist arthroscopy, an outpatient surgical procedure. Tiny instruments = small incisions Arthroscopy allows doctors to see inside the body using a miniature camera, which is inserted through a small incision called a portal. The camera then projects microscopic details from inside the body onto a television monitor. That enables a surgeon to find problems and correct them through surgery by using tiny instruments.

According to the National Center for Health Statistics, there are roughly three million visits to doctors' offices each year for wrist-related problems. Of those problems, more than two million are due to injuries

Variety of uses
Conditions of the wrist that can cause pain and be improved through wrist arthroscopy include synovitis, gout and rheumatoid arthritis. Other disorders can include tears of cartilage and ligaments, fractures and cysts.

"Most people come in because of pain and swelling, or because of an injury," Dr. Hendrickson said. He has been performing wrist arthroscopy at Waterbury Hospital since 1988, averaging about 35 such procedures each year, and he sees how his patients have been helped by the procedure.

"Recovery is so much quicker [with arthroscopy] than with an open incision," he said. "Patients are out of work less time and the procedure costs less."

Getting back in the swing
Getting back to functional activity with a wrist can take from one to six weeks. "I'm feeling a lot better," said Bouchard, who had the surgery in January.

Wrist arthroscopy is an outgrowth of knee and shoulder arthroscopy, which are done on much larger joints. As medical instruments and cameras became smaller, "arthroscopy was applied to other joints, including the wrist," according to the American Academy of Orthopaedic Surgeons.

Procedures don't take long. Most last about 45 minutes with patients staying awake under a regional anesthesia. About 99 percent of arthroscopy procedures are done on an outpatient basis. In Bouchard's case, Dr. Hendrickson was able to communicate with him during the procedure through an interpreter who remained in the operating room. All hearing impaired patients are offered this service, the doctor explained.