Arthroscopy and Endoscopy of the Hand, Wrist and Elbow: Principle and Practice

Foreword
Preface
Acknowledgments
Contents
Part I: Basic Knowledge
	1: Wrist Portals and Arthroscopic Anatomy
		1.1	 Dorsal Radiocarpal Portals
			1.1.1	 1/2 Portal
				1.1.1.1	 Visualized Structures
			1.1.2	 3/4 Portal
				1.1.2.1	 Visualized Structures
			1.1.3	 4/5 Portal
				1.1.3.1	 Visualized Structures
			1.1.4	 6R Portal
				1.1.4.1	 Visualized Structures
			1.1.5	 6U Portal
				1.1.5.1	 Visualized Structures
		1.2	 Midcarpal Dorsal Portals
			1.2.1	 Radial Midcarpal Portal (RMC)
				1.2.1.1	 Visualized Structures
			1.2.2	 Ulnar Midcarpal Portal (UMC)
				1.2.2.1	 Visualized Structures
		1.3	 Volar Portals
			1.3.1	 Volar Radial (VR) Portal
				1.3.1.1	 Visualized Structures (Fig. 1.23)
			1.3.2	 Volar Ulnar (VU) Portal
				1.3.2.1	 Visualized Structures (Fig. 1.26)
			1.3.3	 Volar Central Portal
				1.3.3.1	 Establishment of the Volar Central Radiocarpal Portal
				1.3.3.2	 Visualized Structures in the Radiocarpal Joint
				1.3.3.3	 Establishment of the Volar Central Midcarpal Portal
				1.3.3.4	 Visualized Structures in the Midcarpal Joint
		References
	2: Surgical Arthroscopy Anatomy of the Elbow
		2.1	 Introduction
		2.2	 Surgical Anatomy of the Elbow
			2.2.1	 Surface Anatomy
			2.2.2	 Osteology
			2.2.3	 Capsule
			2.2.4	 Ligaments
				2.2.4.1	 Medial Collateral Ligament Complex
				2.2.4.2	 Lateral Collateral Ligament Complex
			2.2.5	 Musculature
			2.2.6	 Neurovascular Structures
		References
	3: Set-Up, Equipment, and Surgical Instruments
		3.1	 Introduction
		3.2	 Wrist Arthroscopy
			3.2.1	 Set Up
			3.2.2	 Dry Arthroscopy
			3.2.3	 Anesthesia
			3.2.4	 Instrumentation
				3.2.4.1	 Arthroscope
				3.2.4.2	 Trocar-Cannula
				3.2.4.3	 Needle
				3.2.4.4	 Arthroscopic Instruments
					Mini Probe
					Micro Grasper
					Suction Punch
					Micro-Punch
					Motorized Instruments (Fig. 3.14)
					Radiofrequency Probes
					TFCC Repair Guide
					Micro-vector
			3.2.5	 Arthroscopic Portals
				3.2.5.1	 Radiocarpal Joint (Fig. 3.20)
					1–2 Portal
					3–4 Portal
					4–5 Portal
					6–R Portal
					6-U Portal
				3.2.5.2	 Midcarpal Joint (Fig. 3.21)
					Midcarpal Radial (MCR) Portal
					Midcarpal Ulnar (MCU) Portal
					Scaphotrapeziotrapezoid (STT) Portal
					Triquetro-Hamate (TH) Portal
				3.2.5.3	 Distal Radioulnar Joint (Fig. 3.22)
					DRUJ-P and DRUJ-D Portals
		3.3	 Thumb Carpometacarpal Joint (CMCJ) Arthroscopy
			3.3.1	 Set-Up
			3.3.2	 Thumb CMCPJ Portals
				3.3.2.1	 1U Portal
				3.3.2.2	 1R Portal
				3.3.2.3	 Thenar Portal
			3.3.3	 Instrumentations
		3.4	 Metacarpophalangeal Joint (MCPJ) Arthroscopy
			3.4.1	 Set-Up
			3.4.2	 Instrumentations
			3.4.3	 MCPJ Portals (Fig. 3.25)
				3.4.3.1	 Dorsoradial Portal
				3.4.3.2	 Dorsoulnar Portal
		3.5	 Proximal Interphalangeal Joint (PIPJ) Arthroscopy
			3.5.1	 Set-Up
			3.5.2	 Instrumentations
			3.5.3	 PIPJ Portals
		3.6	 Elbow Arthroscopy
			3.6.1	 Set-Up
			3.6.2	 Anesthesia
			3.6.3	 Instrumentation
				3.6.3.1	 Arthroscope
				3.6.3.2	 Trocar-Cannula
				3.6.3.3	 Slotted Cannula
				3.6.3.4	 Needle
				3.6.3.5	 Probe
				3.6.3.6	 Grasper
				3.6.3.7	 Suction Punch
				3.6.3.8	 Punch
				3.6.3.9	 Motorized Instruments
				3.6.3.10	 Radiofrequency Probes
			3.6.4	 Elbow Arthroscopy Portals
				3.6.4.1	 Proximal Anteromedial Portal (Fig. 3.35)
				3.6.4.2	 Proximal Anterolateral Portal (Fig. 3.36)
				3.6.4.3	 Midlateral Portal (Fig. 3.36)
				3.6.4.4	 Straight Posterior Portal (Fig. 3.37)
				3.6.4.5	 Proximal Posterolateral Portal (Fig. 3.37)
		References
Part II: Hand and Wrist Arthroscopy
	4: Radio-Carpal and Midcarpal Arthroscopy
		4.1	 Arthroscopic Approaches to the RadioCarpal and MidCarpal Joint
			4.1.1	 Introduction
			4.1.2	 Indications
			4.1.3	 Contraindications
			4.1.4	 Author’s Preferred Technique
				4.1.4.1	 Preoperative Planning
				4.1.4.2	 Patient Positioning
				4.1.4.3	 Portal Design
					1/2 Portal
					3/4 Portal
					4/5 Portal
					6R Portal
					6U Portal
					Volar Radial Portal (VR)
					Volar Ulnar Portal (VU)
					MCU Portal
					MCR Portal
					STT-U Portal
					Volar Ulnar Midcarpal (VUMC) and Volar Radial Midcarpal (VRMC) Portals
					DDRUJ Portal
					PDRUJ Portal
					Volar DRUJ Portal (VDRU)
					Direct Foveal (DF) Portal
				4.1.4.4	 Step-by-Step Description of the Techniques
					3/4 Portal
					4/5 Portal
					6R Portal
					1/2 Portal
					VR Portal
					VU Portal
					MCU Portal
					MCR Portal
					STT-U Portal
					VUMC and VRMC Portal
					Distal DRUJ Portal (DDRUJ)
					Direct Fovea Portal (DF)
				4.1.4.5	 Complications and Management
					Failure to Achieve the Procedure
					Cartilage Lesions
					Complex Regional Pain Syndrome (CRPS)
					Nerve Lesions
					Finger Traction
					Stiffness
					Loose Bodies
					Hematoma and Fluid Extravasation
					Tendon Lacerations
				4.1.4.6	 Postoperative Care
				4.1.4.7	 Outcomes
			4.1.5	 Summary
		4.2	 Arthroscopic Management of Acute and Chronic Scapholunate Ligament Injuries
			4.2.1	 Arthroscopic Management of Acute Scapholunate Ligament Injuries
				4.2.1.1	 Arthroscopic K-Wire Fixation of Acute Scapholunate Ligament Injuries
					Indications
					Contraindications
				4.2.1.2	 Management of Acute Geissler Grade 4 Tears
					Indications
					Contraindications
			4.2.2	 Arthroscopic Management of Chronic Scapholunate Ligament Injuries
				4.2.2.1	 Thermal Collagen Shrinkage
				4.2.2.2	 Arthroscopic Scapholunate Ligament Repair
					Indications
					Contraindications
				4.2.2.3	 Arthroscopic Proximal Row Carpectomy and Radial Styloidectomy
					Indications
					Contraindications
			4.2.3	 Summary
		4.3	 Acute Lunotriquetral Ligament Injury
			4.3.1	 Introduction
			4.3.2	 Anatomy
			4.3.3	 Pathomechanics
			4.3.4	 Pathogenesis
				4.3.4.1	 Perilunate Injury
				4.3.4.2	 Reverse Perilunate Injury
				4.3.4.3	 Dorsally Applied Force
				4.3.4.4	 Other Etiologies
			4.3.5	 Patient History and Physical Findings
			4.3.6	 Differential Diagnosis
			4.3.7	 Imaging and Other Diagnostic Studies
				4.3.7.1	 Radiography
					Plain Films
					Videofluoroscopy
				4.3.7.2	 Arthrography and Magnetic Resonance Arthrography
				4.3.7.3	 Other Imaging Modalities
				4.3.7.4	 Wrist Arthroscopy
			4.3.8	 Classification
			4.3.9	 Treatment
				4.3.9.1	 Nonoperative Management
				4.3.9.2	 Surgical Management
					Preoperative Planning
					Positioning
					Techniques
						Arthroscopic Débridement
						Direct Lunotriquetral Ligament Repair
						Lunotriquetral Ligament Reconstruction with Distally Based Extensor Carpi Ulnaris Strip
						Combined Repair
						Arthrodesis
				4.3.9.3	 Postoperative Care
			4.3.10	 Outcomes
			4.3.11	 Complications
			4.3.12	 Conclusion
		4.4	 Arthroscopic Management of Chronic Lunotriquetral Instability
			4.4.1	 Introduction
			4.4.2	 Indications
			4.4.3	 Contraindications
			4.4.4	 Techniques
				4.4.4.1	 Preoperative Planning
				4.4.4.2	 Patient Positioning
				4.4.4.3	 Portal Design
				4.4.4.4	 Step-by-Step Description of the Techniques
					Arthroscopic Capsuloligamentous Suture of the LTIL
						A: Arthroscopic Capsuloligamentous Suture of the Dorsal Portion of the Lunotriquetral Interosseous Ligament
						B: Arthroscopic Capsuloligamentous Suture of the Volar Portion of the Lunotriquetral Interosseous Ligament
						Complications and Management
						Postoperative Care
					Arthroscopic Volar LTIL and Dorsal Radiocarpal Ligament Reconstruction
						Complications and Management
						Postoperative Care
			4.4.5	 Summary
		4.5	 Extrinsic Wrist Ligaments and Arthroscopy
			4.5.1	 Clinical Diagnosis
			4.5.2	 Peri-Scaphoid Injury
			4.5.3	 Ulnocarpal Lesions
			4.5.4	 Midcarpal Lesions
		4.6	 Arthroscopic Management of Midcarpal Instability
			4.6.1	 Introduction
				4.6.1.1	 Grading of Palmar Midcarpal Instability
				4.6.1.2	 Natural History
				4.6.1.3	 Diagnosis
				4.6.1.4	 Treatment Options
				4.6.1.5	 Thermal Capsular Shrinkage
			4.6.2	 Indications
			4.6.3	 Contraindications
			4.6.4	 Author Preferred Technique
				4.6.4.1	 Preoperative Planning
				4.6.4.2	 Patient Positioning
				4.6.4.3	 Portal Design
				4.6.4.4	 Step-by-Step Description of the Technique
				4.6.4.5	 Complications and Management
				4.6.4.6	 Postoperative Care
				4.6.4.7	 Outcome
			4.6.5	 Summary
		4.7	 Arthroscopic Arthrolysis of the Wrist
			4.7.1	 Introduction
			4.7.2	 Indications
			4.7.3	 Contraindications
			4.7.4	 Author Preferred Technique (Tip and Pearls Included)
				4.7.4.1	 Preoperative Planning
				4.7.4.2	 Patient Positioning and Portal Design
				4.7.4.3	 Step-by-Step Description of the Techniques
					Radiocarpal Joint
						Ancillary Procedures
					Midcarpal Joint
					Distal Radioulnar Joint
						Indications and Contraindications
						Technique
			4.7.5	 Complications and Management
			4.7.6	 Postoperative Rehabilitation
			4.7.7	 Outcome
			4.7.8	 Summary
		4.8	 Arthroscopic Treatment of Acute Scaphoid Fractures
			4.8.1	 Introduction
			4.8.2	 Indications
			4.8.3	 Contraindications
			4.8.4	 Surgical Technique
				4.8.4.1	 Setup
				4.8.4.2	 Wrist Arthroscopy
				4.8.4.3	 Displaced Acute Scaphoid Fracture Fixation
				4.8.4.4	 Subacute Scaphoid Fracture Fixation
				4.8.4.5	 Postoperative Care
				4.8.4.6	 Complications
			4.8.5	 Conclusion
		4.9	 Arthroscopic Management of Scaphoid Nonunion and SNAC Lesions
			4.9.1	 Introduction
			4.9.2	 Indications for Arthroscopic Techniques
				4.9.2.1	 Autogenous Bone Graft (ABG)
				4.9.2.2	 Partial Carpal Fusion
				4.9.2.3	 Radial Styloidectomy
				4.9.2.4	 Proximal Row Carpectomy
				4.9.2.5	 Scaphoid Distal Pole Resection
			4.9.3	 Contraindications to Arthroscopic-Assisted Techniques
				4.9.3.1	 Autogenous Bone Transplantation
				4.9.3.2	 Partial Carpal Fusion
				4.9.3.3	 Radial Styloidectomy
				4.9.3.4	 Proximal Row Carpectomy
				4.9.3.5	 Scaphoid Distal Pole Resection
			4.9.4	 Author Preferred Techniques
				4.9.4.1	 Preoperative Planning
				4.9.4.2	 Patient Positioning
				4.9.4.3	 Portal Design
				4.9.4.4	 Step-by-Step Description of the Techniques
					Arthroscopically Assisted Scaphoid Nonunion Repair and Autogenous Bone Graft
					Arthroscopically Assisted Radial Styloidectomy
					Arthroscopically Assisted Proximal Row Carpectomy
					Arthroscopically Assisted Distal Scaphoid Pole Resection
					Arthroscopically Assisted Partial Wrist Fusion
				4.9.4.5	 Complications and Management
					Arthroscopically Assisted Scaphoid Nonunion Repair and Autogenous Bone Graft
					Arthroscopically Assisted Radial Styloidectomy
					Arthroscopically Assisted Partial Scaphoidectomy
					Arthroscopically Assisted Proximal Row Carpectomy
					Arthroscopically Assisted Partial Wrist Fusion
				4.9.4.6	 Postoperative Care
					Arthroscopically Assisted Scaphoid Nonunion Repair and Autogenous Bone Graft
					Arthroscopically Assisted Radial Styloidectomy
					Arthroscopically Assisted Partial Scaphoidectomy
					Arthroscopically Assisted Proximal Row Carpectomy
					Arthroscopically Assisted Partial Wrist Fusion
				4.9.4.7	 Outcome
					Arthroscopically Assisted Scaphoid Nonunion Repair and Autogenous Bone Graft
					Arthroscopically Assisted Partial Scaphoidectomy
					Arthroscopically Assisted Radial Styloidectomy
					Arthroscopically Assisted Proximal Row Carpectomy
					Arthroscopically Assisted Partial Wrist Fusion
			4.9.5	 Summary
		4.10	 Arthroscopic Management of Distal Radius Fractures
			4.10.1	 Introduction
			4.10.2	 Indications
			4.10.3	 Contraindications
			4.10.4	 Author Preferred Techniques
				4.10.4.1	 Preoperative Planning
				4.10.4.2	 Patient Positioning
					Technique
						Traditional Part
						Arthroscopic Part
							The Dry Technique
				4.10.4.3	 Step-by-Step Description of the Technique
					Extra-Articular and Intra-Articular Fracture with Acceptable Fragments Reduction
					Two-Part Fractures
					Three-Part Fractures
					Multiple Displaced Fragments
					Particular Conditions
						Depressed Fragments
						Elevated Fragments
						A Large Distracted Dorsal Fragment
						Free Osteochondral Fragments (FOF)
				4.10.4.4	 Associated Injuries
				4.10.4.5	 Complication and Management
				4.10.4.6	 Postoperative Care
				4.10.4.7	 Outcome
			4.10.5	 Summary
		4.11	 Arthroscopic Management of Intra-Articular Malunions of the Distal Radius
			4.11.1	 Introduction
			4.11.2	 Indications
			4.11.3	 Contraindication
			4.11.4	 Author Preferred Technique
				4.11.4.1	 Preoperative Planning
				4.11.4.2	 Patient Positioning and Step-by-Step Technique Description
					Arthroscopically Assisted Corrective Osteotomy of the Distal Radius
					Arthroscopic Arthrolysis and/or Resection Arthroplasty
					Procedure
				4.11.4.3	 Complication and Management
				4.11.4.4	 Postoperative Care
			4.11.5	 Summary
		4.12	 The Role of Wrist Arthroscopy in Perilunate Injuries
			4.12.1	 Introduction
			4.12.2	 Indications and Contraindications
			4.12.3	 Surgical Technique
				4.12.3.1	 Arthroscopic Treatment of Perilunate Dislocations
				4.12.3.2	 Scapholunate Augmentation and Management of Associated Injuries
				4.12.3.3	 Arthroscopic Treatment of Perilunate Fracture Dislocations
				4.12.3.4	 Associated Injuries in PLFDs
				4.12.3.5	 Postoperative Care
				4.12.3.6	 Practical Tips
			4.12.4	 Complications
			4.12.5	 Conclusion
		4.13	 Arthroscopic Management of Kienbock’s Disease
			4.13.1	 Introduction
			4.13.2	 Initial Management
				4.13.2.1	 Investigations
			4.13.3	 Arthroscopic Assessment
			4.13.4	 Planning Management
			4.13.5	 Arthroscopic Techniques
			4.13.6	 Arthroscopic Scaphocapitate Fusion
				4.13.6.1	 Surgical Steps
				4.13.6.2	 Post-op Management and Rehabilitation
			4.13.7	 Arthroscopic Radioscapholunate Fusion
				4.13.7.1	 Surgical Steps
				4.13.7.2	 Post-op Management and Rehab
				4.13.7.3	 Results
			4.13.8	 Arthroscopic Proximal Row Carpectomy
				4.13.8.1	 Surgical Steps
				4.13.8.2	 Post-op Management and Rehab
				4.13.8.3	 Results
			4.13.9	 Summary
		4.14	 Arthroscopic Management of Inflammatory and Degenerative Arthritis of the Wrist
			4.14.1	 Introduction
			4.14.2	 Indications
				4.14.2.1	 For Arthroscopic Synovectomy
				4.14.2.2	 For Arthroscopic Radial Styloidectomy
			4.14.3	 Contraindication
			4.14.4	 Author’s Preferred Technique
				4.14.4.1	 Arthroscopic Synovectomy
				4.14.4.2	 Arthroscopic Radial Styloidectomy
			4.14.5	 Summary
		4.15	 Arthroscopic Management of Osteochondral Lesions
			4.15.1	 Introduction
			4.15.2	 Classification
			4.15.3	 Indications and Treatment Options
			4.15.4	 Repair Techniques
				4.15.4.1	 Arthroscopic Debridement
				4.15.4.2	 Stimulation of the Bone Marrow (Microfractures)
				4.15.4.3	 Scaffold-Guided Regenerative Medicine
					Hyaluronan-Based Scaffold
					Chitosan Soluble Polymer Scaffold
					Autologous Matrix-Induced Chondrogenesis (AMIC)
					Collagen-Augmented MS
					Cartilage ECM Scaffold
			4.15.5	 Reconstruction Techniques
				4.15.5.1	 Osteochondral Autologous Transfer (OAT)
				4.15.5.2	 Osteochondral Allografts (OCA)
			4.15.6	 Regeneration Techniques (ACI/MACI)
		4.16	 Arthroscopic Volar Wrist Ganglionectomy
			4.16.1	 Introduction
			4.16.2	 Indications
			4.16.3	 Contraindications
			4.16.4	 Author’s Preferred Technique
				4.16.4.1	 Preoperative Planning
				4.16.4.2	 Patient Positioning
				4.16.4.3	 Portal Design
				4.16.4.4	 Step-by-Step Description of Technique
				4.16.4.5	 Complications
				4.16.4.6	 Postoperative Care
				4.16.4.7	 Outcome
			4.16.5	 Summary
		4.17	 Arthroscopic Dorsal Wrist Ganglionectomy
			4.17.1	 Introduction
			4.17.2	 Indications
			4.17.3	 Contraindications
			4.17.4	 Author’s Preferred Technique
				4.17.4.1	 Preoperative Planning
				4.17.4.2	 Patient Positioning
				4.17.4.3	 Portal Design
				4.17.4.4	 Technique
				4.17.4.5	 Complications
				4.17.4.6	 Postoperative Care
				4.17.4.7	 Outcome
			4.17.5	 Summary
		References
	5: Ulnocarpal Arthroscopy and Distal Radioulnar Arthroscopy
		5.1	 Arthroscopic Repair of Triangular Fibrocartilage (TFCC) Peripheral Tear
			5.1.1	 Introduction
			5.1.2	 Indications
			5.1.3	 Contraindications
			5.1.4	 Authors’ Preferred Technique
				5.1.4.1	 Preoperative Planning
				5.1.4.2	 Patient Positioning
				5.1.4.3	 Portal Design
				5.1.4.4	 Step-by-Step Description of the Technique
				5.1.4.5	 Complications and Management
				5.1.4.6	 Postoperative Care
				5.1.4.7	 Outcome
			5.1.5	 Summary
		5.2	 Arthroscopic TFCC Ligamentoplasty
			5.2.1	 Introduction
			5.2.2	 Indications
			5.2.3	 Contraindications
			5.2.4	 Author Preferred Technique
				5.2.4.1	 Preoperative Planning
				5.2.4.2	 Patient and Medical Team Positioning
				5.2.4.3	 Portal Design
				5.2.4.4	 Step-by-Step Description of the Technique
					I. Exploratory Arthroscopy and Cleaning of the Ulnar Border
					II. Extraction of the Tendinous Graft
					II. Creating The Ulnar Tunnel
					III. Creating the Radial Tunnels
					IV. Passing the Tendon Graft to the Ulnar Tunnel
					V. Fixing the Tendon Graft in the Radial and Ulnar Tunnels
				5.2.4.5	 Complications and Management.
				5.2.4.6	 Postoperative Care
				5.2.4.7	 Outcome
			5.2.5	 Summary
		5.3	 Arthroscopic Management of Ulnocarpal Impaction Syndrome and Ulnar Styloid Impaction Syndrome
			5.3.1	 Introduction
			5.3.2	 Pathomechanics and Mechanism of Injury
				5.3.2.1	 Ulnar Variance
				5.3.2.2	 Anatomy and Biomechanics of the Carpus
				5.3.2.3	 Activities of Daily Living
			5.3.3	 Clinical Presentation and Diagnosis
				5.3.3.1	 History
				5.3.3.2	 Examination
				5.3.3.3	 Imaging
					Plain Radiographs
					Magnetic Resonance Imaging
			5.3.4	 Treatment
				5.3.4.1	 Conservative
				5.3.4.2	 Surgical Treatment
					Ulnar-Shortening Osteotomy (USO)
					Wafer Procedure
		References
	6: Trapeziometacarpal and Scaphotrapezial Arthroscopy; Metacarpophalangeal Arthroscopy of the Lesser Rays
		6.1	 Arthroscopic Treatment of Intra-Articular Fracture–Dislocations of the First Metacarpal Base
			6.1.1	 Introduction
			6.1.2	 Indications
			6.1.3	 Contraindications
			6.1.4	 Author’s Preferred Technique
				6.1.4.1	 Preoperative Planning
				6.1.4.2	 Patient Positioning
				6.1.4.3	 Portal Design
				6.1.4.4	 Step-by-Step Description of the Technique
					K-Wire Placement
					Fragment Reduction
					Fragment Fixation
				6.1.4.5	 Complications and Management
				6.1.4.6	 Postoperative Care
			6.1.5	 Summary
		6.2	 Arthroscopic Management of Trapeziometacarpal Osteoarthritis: Arthroscopic Complete Trapeziectomy and Suspension Arthroplasty: “Three-Steps Arthroscopic Trapeziectomy Technique”
			6.2.1	 Introduction
			6.2.2	 Indications
			6.2.3	 Contraindications
			6.2.4	 Author Preferred Technique: “Three-Steps Arthroscopic Trapeziectomy”
				6.2.4.1	 Preoperative Planning
					Work in Pairs
				6.2.4.2	 Patient Positioning
				6.2.4.3	 Portal Design
				6.2.4.4	 Step-by-Step Description of the Technique
					Step 1: Resection of Zone 1 Trapezium
					Step 2: Resection of Zone 2 (Volar Radial Portion) Trapezium
					Step 3: Resection of Zone 3 (Dorsal Radial Portion) Trapezium
					Proximal Resection of the Trapezoid
					Colocation of the Suture Button
				6.2.4.5	 Complications and Management
				6.2.4.6	 Postoperative Care
			6.2.5	 Summary
		6.3	 Arthroscopic Management of Scapho-Trapezio-Trapezoid Joint Arthritis
			6.3.1	 Introduction
			6.3.2	 Indications
			6.3.3	 Contraindications
			6.3.4	 Author’s Preferred Technique
				6.3.4.1	 Preoperative Planning
				6.3.4.2	 Patient Positioning
				6.3.4.3	 Portal Design
				6.3.4.4	 Step-by-Step Description
					Diagnostic Arthroscopy and Synovectomy
					Distal Resection of the Scaphoid
					Interposition
				6.3.4.5	 Complications and Management
				6.3.4.6	 Postoperative Management
				6.3.4.7	 Outcome
			6.3.5	 Summary
		6.4	 Arthroscopic Management of Thumb Basal Joint Instability
			6.4.1	 Introduction
				6.4.1.1	 Surgical Decision
			6.4.2	 Indications
			6.4.3	 Contraindications
			6.4.4	 Operative Technique
				6.4.4.1	 Instruments
				6.4.4.2	 Patient Preparation and Positioning
				6.4.4.3	 CMC Joint Portals
				6.4.4.4	 Arthroscopic Techniques
				6.4.4.5	 Postoperative Care and Rehabilitation Program
				6.4.4.6	 Complications
				6.4.4.7	 Results
			6.4.5	 Conclusion
		6.5	 Endoscopic Resection of Dorsal Boss of the Second Carpometacarpal Joint
			6.5.1	 Introduction
			6.5.2	 Indications
			6.5.3	 Contra-Indications
			6.5.4	 Author Preferred Technique
				6.5.4.1	 Preoperative Planning
				6.5.4.2	 Patient Positioning
				6.5.4.3	 Portal Design
				6.5.4.4	 Step-By-Step Description of the Technique
				6.5.4.5	 Complications and Management
				6.5.4.6	 Postoperative Care
			6.5.5	 Summary
		6.6	 Arthroscopic Trapeziometacarpal Arthrodesis
			6.6.1	 Introduction
			6.6.2	 Indications
			6.6.3	 Contra-Indications
			6.6.4	 Author Preferred Technique
				6.6.4.1	 Preoperative Planning
				6.6.4.2	 Patient Positioning
				6.6.4.3	 Portal Design
				6.6.4.4	 Step-By-Step Description of the Technique
				6.6.4.5	 Complications and Management
				6.6.4.6	 Postoperative Care
			6.6.5	 Summary
		6.7	 Arthroscopic Hemitrapeziectomy and Suture Button Suspensionplasty for Thumb CMC Joint Arthritis
			6.7.1	 Introduction
			6.7.2	 Indications
				6.7.2.1	 Eaton Stage I
				6.7.2.2	 Eaton Stage II and III
				6.7.2.3	 Eaton Stage IV
			6.7.3	 Contraindications
			6.7.4	 Author’s Preferred Technique
				6.7.4.1	 Preoperative Planning
				6.7.4.2	 Patient Positioning and Set-Up
				6.7.4.3	 Portal Design
				6.7.4.4	 Step-by-Step Description of the Technique
					Arthroscopic Hemitrapeziectomy
					Arthroscopic-Assisted Suture Button Suspensionplasty
				6.7.4.5	 Complications and Management
				6.7.4.6	 Postoperative Care
			6.7.5	 Summary
		References
	7: Metacarpophalangeal Arthroscopy
		7.1	 Introduction
		7.2	 Indications for MCP Arthroscopy [2, 5, 6]
		7.3	 Contra-Indications for MCP Arthroscopy
		7.4	 Author Preferred Technique
			7.4.1	 Pre-operative Planning
			7.4.2	 Patient Positioning
			7.4.3	 Portal Design
			7.4.4	 Step-by-Step Description of the Technique
			7.4.5	 Complications and Management
				7.4.5.1	 Technical Tips to Avoid Complications
			7.4.6	 Postoperative Care
				7.4.6.1	 Early Phase (1 Week After Operation): Edema Control + Joint Movement + Muscle Strength Training
				7.4.6.2	 Intermediate Phase (2–3 Weeks After Operation)
				7.4.6.3	 Recovery Phase (4–6 Weeks After Operation)
			7.4.7	 Outcome
		7.5	 Summary
		References
	8: Interphalangeal Arthroscopy
		8.1	 Introduction
		8.2	 Indications
			8.2.1	 PIP Joint Arthroscopy
			8.2.2	 DIP Joint Arthroscopy
		8.3	 Contra-Indications
		8.4	 Author’s Preferred Technique
			8.4.1	 Pre-operative Planning
			8.4.2	 Patient and Medical Team Positioning
			8.4.3	 Portal Design
			8.4.4	 Step-by-Step Description of the Techniques
			8.4.5	 Complications
			8.4.6	 Postoperative Care
			8.4.7	 Outcome
				8.4.7.1	 PIP Joint Arthroscopy
				8.4.7.2	 DIP Joint Arthroscopy
		8.5	 Summary
		References
Part III: Hand and Wrist Endoscopy
	9: Extensor Tendoscopy
		9.1	 Endoscopic Synovectomy of Extensor Tendons
			9.1.1	 Introduction
			9.1.2	 Indication
			9.1.3	 Contra-Indications
			9.1.4	 Author Preferred Technique
				9.1.4.1	 Pre-operative Planning
				9.1.4.2	 Patient Positioning
				9.1.4.3	 Portal Design
				9.1.4.4	 Step-by-Step Description of the Technique
				9.1.4.5	 Complications and Management
				9.1.4.6	 Post-operative Care
			9.1.5	 Summary
		9.2	 Endoscopic De Quervain’s Release
			9.2.1	 Introduction
			9.2.2	 Indications
			9.2.3	 Contra-Indications
			9.2.4	 Author Preferred Technique
				9.2.4.1	 Pre-operative Planning
				9.2.4.2	 Patient Positioning
				9.2.4.3	 Portal Design
				9.2.4.4	 Step-by-Step Description of the Technique
				9.2.4.5	 Complications and Management
				9.2.4.6	 Post-operative Care
				9.2.4.7	 Outcome
			9.2.5	 Summary
		9.3	 Endoscopic Management of Stenosing Tenosynovitis of Extensor Carpi Ulnaris Tendon
			9.3.1	 Introduction
			9.3.2	 Indications of Endoscopic Release
			9.3.3	 Contra-Indications
			9.3.4	 Author Preferred Technique
				9.3.4.1	 Pre-operative Planning
				9.3.4.2	 Patient Positioning
				9.3.4.3	 Portal Design
				9.3.4.4	 Description of Procedure
				9.3.4.5	 Complications and Management
				9.3.4.6	 Postoperative Care
			9.3.5	 Summary
		References
	10: Flexor Tendoscopy, Endoscopy of the Ulnar Bursa, Radial Bursa, MidPalmar Space, and Thenar Space
		10.1	 Introduction
		10.2	 Indications
		10.3	 Contra-Indications
		10.4	 Author Preferred Techniques
			10.4.1	 Pre-operative Planning
			10.4.2	 Patient Positioning
			10.4.3	 Portal Design
			10.4.4	 Step-by-Step Description of the Techniques
			10.4.5	 Risks and Complications
			10.4.6	 Post-operative Care
			10.4.7	 Outcome
		10.5	 Summary
		References
	11: Endoscopic Ganglionectomy
		11.1	 Introduction
			11.1.1	 Etiology
			11.1.2	 Histopathology
			11.1.3	 Pathoanatomy and Types
				11.1.3.1	 Dorsal Wrist Ganglions
				11.1.3.2	 Volar Wrist Ganglions
			11.1.4	 Management
				11.1.4.1	 Advantage of Endoscopic Approach Over Arthroscopic Approach
				11.1.4.2	 Pitfalls of Endoscopic Approach
		11.2	 Indications
		11.3	 Contra-Indications
		11.4	 Author Preferred Techniques
			11.4.1	 Pre-operative Planning
			11.4.2	 Patient Positioning
			11.4.3	 Portal Design
				11.4.3.1	 Dorsal Wrist Endoscopic Ganglionectomy
				11.4.3.2	 Radial Volar Wrist Endoscopic Ganglionectomy
			11.4.4	 Step-by-Step Description of the Technique
				11.4.4.1	 Dorsal Wrist Endoscopic Ganglionectomy
				11.4.4.2	 Radial Volar Wrist Endoscopic Ganglionectomy
			11.4.5	 Complications and Management
			11.4.6	 Post-operative Care
		11.5	 Summary
		References
	12: Endoscopic Carpal Tunnel Release (EndoTech Supraretinacular Technique)
		12.1	 Introduction
		12.2	 Indications
		12.3	 Contra-Indications
		12.4	 Author Preferred Technique
			12.4.1	 Pre-operative Planning
			12.4.2	 Patient Positioning
			12.4.3	 Portal Design
			12.4.4	 Step-by-Step Description of the Technique
			12.4.5	 Complications and Management
			12.4.6	 Post-operative Care
			12.4.7	 Outcome
		12.5	 Summary
		References
	13: Endoscopic Release of the Guyon Canal and Pisohamate Hiatus
		13.1	 Introduction
		13.2	 Indications
		13.3	 Contraindications
		13.4	 Author Preferred Technique
			13.4.1	 Preoperative Planning
			13.4.2	 Patient Positioning
			13.4.3	 Portal Design
			13.4.4	 Step-by-Step Description of the Technique
			13.4.5	 Complications and Management
			13.4.6	 Postoperative Care
		13.5	 Summary
		References
	14: Endoscopic Trigger Finger Release
		14.1	 Introduction
		14.2	 Indications
		14.3	 Contraindications
		14.4	 Author Preferred Technique
		14.5	 Summary
		References
	15: Endoscopic (EndoTech) Dupuytren’s Fasciectomy
		15.1	 Introduction
		15.2	 Indications
		15.3	 Contraindications
		15.4	 Author Preferred Technique
			15.4.1	 Preoperative Planning
			15.4.2	 Patient Positioning
			15.4.3	 Portal Design
			15.4.4	 Step-by-Step Description of the Technique
			15.4.5	 Complications and Management
			15.4.6	 Postoperative Care
			15.4.7	 Outcome
		15.5	 Summary
		References
Part IV: Elbow Arthroscopy
	16: Portals and Basic Arthroscopic Technique to Reduce Risk of Nerve Injury
		16.1	 Introduction
		16.2	 Indications
		16.3	 Contraindications
		16.4	 Author’s Preferred Portals and Techniques
			16.4.1	 Patient Positioning
			16.4.2	 Portals of Anterior Compartment
			16.4.3	 Portals of Posterior Compartment
			16.4.4	 Top Ten Tips to Minimize Nerve Injury during Elbow Arthroscopy (From Shawn O’Driscoll)
		16.5	 Summary
		Bibliography
	17: Arthroscopic Management of Inflammatory Arthritis Affecting the Elbow
		17.1	 Introduction
		17.2	 Indications [4, 7, 8]
		17.3	 Contraindications [4, 7]
		17.4	 Arthroscopic Technique
			17.4.1	 Preoperative Planning
			17.4.2	 Patient Positioning
			17.4.3	 Portal Design [4, 7, 8]
			17.4.4	 Operative Technique [4, 7, 8]
			17.4.5	 Complications and Management [4, 7, 8, 11–13]
			17.4.6	 Postoperative Care
			17.4.7	 Outcomes
		17.5	 Summary
		References
	18: Arthroscopic Management of Osteoarthritis
		18.1	 Introduction
		18.2	 Indications
		18.3	 Contraindications
		18.4	 Author Preferred Technique
			18.4.1	 Preoperative Planning
			18.4.2	 Patient Positioning
			18.4.3	 Portal Design
			18.4.4	 Step-by-Step Description of the Technique
			18.4.5	 Complications and Management
			18.4.6	 Postoperative Care
			18.4.7	 Outcome
		18.5	 Summary
		Bibliography
	19: Arthroscopic Management of Elbow Stiffness
		19.1	 Introduction
		19.2	 Indications
		19.3	 Contraindications
		19.4	 Author Preferred Technique
			19.4.1	 Preoperative Planning
			19.4.2	 Patient Positioning
			19.4.3	 Portal Design
			19.4.4	 Step-by-Step Description of the Technique
			19.4.5	 Complications
			19.4.6	 Postoperative Care
			19.4.7	 Outcome
		19.5	 Summary
		Bibliography
	20: Arthroscopic Management of Lateral Elbow Instability
		20.1	 Introduction
		20.2	 Indications
		20.3	 Contraindications
		20.4	 Authors Preferred Technique
			20.4.1	 Preoperative Planning
			20.4.2	 Patient Positioning
			20.4.3	 Portal Design
			20.4.4	 Step-by-Step Description of the Technique
			20.4.5	 Complications and Management
			20.4.6	 Postoperative Care
		20.5	 Summary
		References
	21: Arthroscopic Management of Medial Elbow Instability
		21.1	 Introduction
			21.1.1	 Biomechanics
			21.1.2	 Pathogenesis
			21.1.3	 Clinical Examination
			21.1.4	 Imaging
			21.1.5	 Medial Elbow Instability Classification
			21.1.6	 Conservative Treatment
		21.2	 Surgical Indications
		21.3	 Contraindication
		21.4	 Author Preferred Surgical Technique
			21.4.1	 Complications
			21.4.2	 Rehabilitation Protocol
		21.5	 Conclusion
		References
	22: Arthroscopic Management of Fractures of the Elbow
		22.1	 Introduction
		22.2	 Indications
			22.2.1	 Radial Head
			22.2.2	 Coronoid Process
		22.3	 Contraindications
		22.4	 Author Preferred Techniques
			22.4.1	 Preoperative Planning
			22.4.2	 Patient Positioning
			22.4.3	 Portal Design
			22.4.4	 Step-by-Step Description of the Techniques
				22.4.4.1	 Radial Head (Lag Screw Fixation)
				22.4.4.2	 Coronoid Process (Antegrade Fixation through an Accessory Anteromedial Portal, Figs. 22.3 and 22.4) [8]
			22.4.5	 Complications and Management
				22.4.5.1	 Nerve Injuries
			22.4.6	 Postoperative Care
				22.4.6.1	 Radial Head (Lag Screw Fixation)
				22.4.6.2	 Coronoid Process (Antegrade Fixation through an Accessory Anteromedial Portal)
		22.5	 Summary
		References
	23: Arthroscopic Management of Lateral Epicondylitis and Symptomatic Minor Instability of the Lateral Elbow (SMILE)
		23.1	 Introduction
		23.2	 Indications
			23.2.1	 Signs of Minor Instability
			23.2.2	 Signs of Intra-Articular Pathology
		23.3	 Contraindications
		23.4	 Author-Preferred Technique
			23.4.1	 Preoperative Planning
			23.4.2	 Patient Positioning
			23.4.3	 Portal Design
			23.4.4	 Step-by-Step Description of the Technique
			23.4.5	 Complications and Management
				23.4.5.1	 Portal Management
				23.4.5.2	 Suture Placement and Management
			23.4.6	 Postoperative Care
			23.4.7	 Outcome
		23.5	 Summary
		References
	24: Arthroscopic Management of Osteochondritis Dissecans
		24.1	 Introduction
		24.2	 Indications for Arthroscopic Debridement
		24.3	 Contraindications
		24.4	 Author-Preferred Technique: Arthroscopic Debridement with Microfracturing
			24.4.1	 Preoperative Planning
			24.4.2	 Patient Positioning
			24.4.3	 Portal Design
			24.4.4	 Step-by-Step Description of the Technique
			24.4.5	 Complications and Management
			24.4.6	 Postoperative Care
			24.4.7	 Outcome
		24.5	 Summary
		References
	25: Arthroscopic Management of Synovial Chondromatosis and Loose Bodies
		25.1	 Introduction
		25.2	 Indications
		25.3	 Contraindications
		25.4	 Author-Preferred Technique
			25.4.1	 Preoperative Planning
			25.4.2	 Patient Positioning
			25.4.3	 Portal Design
			25.4.4	 Step-by-Step Description of the Technique
				25.4.4.1	 Posterior Compartment Arthroscopy
				25.4.4.2	 Lateral Compartment Arthroscopy
				25.4.4.3	 Anterior Compartment Arthroscopy
			25.4.5	 Complications
			25.4.6	 Postoperative Care
			25.4.7	 Outcome
		25.5	 Summary
		References
	26: Arthroscopic Treatment of Valgus Extension Overload Syndrome
		26.1	 Introduction
		26.2	 Indications
		26.3	 Contraindications
		26.4	 Author-Preferred Technique(s)/Procedure(s)
			26.4.1	 Preoperative Planning
			26.4.2	 Patient Positioning
			26.4.3	 Portal Design
			26.4.4	 Step-by-Step Description of the Technique
			26.4.5	 Complications and Management
			26.4.6	 Postoperative Care
			26.4.7	 Outcome
		26.5	 Summary
		References
Part V: Elbow Endoscopy
	27: Endoscopic Management of Distal Biceps Tendon Pathology
		27.1	 Introduction
		27.2	 Anatomy of the Distal Biceps Tendon
		27.3	 Diagnostic Techniques for Distal Biceps Tendinosis and Partial Tears
		27.4	 Open vs. Endoscopic Repair
		27.5	 Indications and Contraindications
		27.6	 Endoscopic-Assisted Footprint Technique
		27.7	 All Endoscopic Technique
		27.8	 Rehabilitation
		27.9	 Pearls and Pitfalls
		27.10	 Avoidable Complications
			27.10.1 LCN Injury
			27.10.2 PIN Injury
			27.10.3 Compartment Syndrome
			27.10.4 Vascular Injury
			27.10.5 Radial Neck Fracture
		27.11	 Summary
		References
	28: Endoscopic Distal Triceps Repair
		28.1	 Introduction
		28.2	 Indications
		28.3	 Contra-indications
		28.4	 Author’s Preferred Technique
			28.4.1	 Pre-operative Planning
			28.4.2	 Patient Positioning
			28.4.3	 Portal Design
			28.4.4	 Step by Step Description of the Technique
			28.4.5	 Complications
			28.4.6	 Post-operative Care
			28.4.7	 Outcome
		28.5	 Summary
		References
	29: Endoscopic Resection of Ganglion, Bicipitoradial Bursa, and Olecranon Bursa
		29.1	 Introduction
		29.2	 Indications of Endoscopic Ganglionectomy
		29.3	 Contra-indications
		29.4	 Author Preferred Techniques
			29.4.1	 Preoperative Planning
			29.4.2	 Patient Positioning
			29.4.3	 Portal Design
			29.4.4	 Step-by-Step Description of the Techniques
		29.5	 Summary
		References
	30: Endoscopic Cubital Tunnel Release
		30.1	 Introduction
		30.2	 Indications
		30.3	 Contra-indications
		30.4	 Author’s Preferred Technique
			30.4.1	 Preoperative Planning
			30.4.2	 Patient and Medical Team Positioning
			30.4.3	 Step-by-Step Description of the Technique
			30.4.4	 Complications and Management
			30.4.5	 Postoperative Care
			30.4.6	 Outcomes
		30.5	 Summary
		References
	31: Endoscopic and Endoscopically Assisted Anterior Transposition of Ulnar Nerve
		31.1	 Introduction
			31.1.1	 Pathology and Anatomy
			31.1.2	 Clinical Presentation
			31.1.3	 Treatment
				31.1.3.1	 In-situ Release vs Anterior Transposition
				31.1.3.2	 Endoscopic Technique
				31.1.3.3	 Development of Endoscopic Techniques
		31.2	 Indications
		31.3	 Contraindications
		31.4	 Author Preferred Techniques
			31.4.1	 Pre-operative Planning
			31.4.2	 Patient Positioning
			31.4.3	 Portal Design
			31.4.4	 Step-by-Step Description of the Techniques
				31.4.4.1	 Endoscopically Assisted Anterior Transposition
				31.4.4.2	 Endoscopic Anterior Transposition
		31.5	 Summary
		References
	32: Endoscopic Pronator Release (Proximal Forearm Median Nerve Decompression)
		32.1	 Introduction
		32.2	 Indications
		32.3	 Contra-indications
		32.4	 Author Preferred Technique
			32.4.1	 Preoperative Planning
			32.4.2	 Patient Positioning
			32.4.3	 Portal Design
			32.4.4	 Step-by-Step Description of the Technique
			32.4.5	 Complications and Management
			32.4.6	 Post-operative Care
			32.4.7	 Outcome
		32.5	 Summary
		References