Small Joint Arthroscopy: Current Clinical Applications

Finger joint arthroscopy has undergone significant evolution over the last few decades. Initially described by YC Chen in 1979, these procedures were primarily utilized for diagnostic purposes. However, with advancements in arthroscopic techniques, their applications have expanded to cover a variety of clinical conditions. This update focuses on notable developments in small joint arthroscopy, particularly concerning the carpometacarpal joint (CMCJ), metacarpophalangeal joints (MCPJs), and proximal interphalangeal joints (PIPJs). 

The CMCJ has emerged as one of the most favored joints for arthroscopy, particularly for treating thumb CMCJ osteoarthritis. Its use has also been applied in managing inflammatory arthritis and in performing fracture reductions in acute trauma cases.  

The MCPJ is an ideal joint for arthroscopic intervention. Its spacious anatomy allows for thorough evaluations of intra-articular pathology, making it suitable for acute trauma procedures like arthroscopic fracture reduction and complex dislocation management. Furthermore, early-stage inflammatory arthritis can often be effectively treated through arthroscopic synovectomy. 

Recent advancements have also improved PIPJ arthroscopy. While traditional dorsal portals restricted assessments to the dorsal side of the joint, the introduction of volar portals has enhanced both diagnostic and therapeutic options, allowing for procedures such as volar capsular contracture release. 

Looking to the future, the potential applications of finger arthroscopy may extend to the thumb interphalangeal joint (IPJ) and distal interphalangeal joint (DIPJ), thereby broadening the range of minimally invasive treatments available for upper extremity conditions. 

In summary, small joint arthroscopy is a dynamic field that continues to enhance the management of various hand and finger pathologies through its minimally invasive techniques. Ongoing research and technological advancements hold promise for further refining these procedures and expanding their indications.