Evaluating complications in wrist arthroscopy: a decade of experience and lessons learned

Purpose: Wrist arthroscopy has significantly advanced the diagnosis and treatment of various wrist pathologies, offering minimally invasive alternatives to traditional open surgery. However, the procedure is not without its complications.This study aims to analyze the incidence, nature, and management of complications in a consecutive series of 358 wrist arthroscopy procedures performed by a single surgeon at a dedicated center. Methods: This retrospective study included 358 patients who underwent wrist arthroscopy between January 2012 and January 2022. Data were extracted from clinical archives, including intraoperative video recordings and patient files. Complications were identified and analyzed using descriptive statistics. Results: Out of 358 cases, 16 complications were identified, resulting in an incidence rate of 4.46%. The most common complication was iatrogenic chondral damage, observed in 10 patients, primarily occurring in the first year of the study period. Other complications included tendon irritation, nerve injuries, and technical errors during specific procedures such as dorsal capsulodesis and 4-Corner Fusion. No cases of compartment syndrome were reported. Conclusions: Wrist arthroscopy, while generally safe and effective, carries a risk of complications that can be mitigated with experience and adherence to meticulous surgical techniques. The study highlights the spectrum of complications encountered during wrist arthroscopy and emphasizes the importance of awareness and appropriate management of these events in clinical practice. Future prospective studies with larger sample sizes are needed to validate these findings and further refine the safety protocols for wrist arthroscopy.