EWAS Wrist Arthroscopy Tour 2014

The European Wrist Arthroscopy Society (EWAS) organizes a Wrist Arthroscopy Tour (WAT) twice a year in order that participants can attend numerous wrist arthroscopies directly in the operating theater in a “compagnonnage” way. The WAT was held in France, and it included three cities and eight surgeons in five hospitals during five days.

This March we visited experts and pioneers of wrist arthroscopy dealing with a variety of clinical problems (see [Table 1]). They often demonstrated techniques they had published, and they discussed as-yet-unpublished observations and innovations. Communication between the organizing surgeons ensured that a wide range of procedures was demonstrated. When the same operation was performed by a different surgeon, there were often subtle differences in technique that were useful to see and discuss. Different centers displayed variety in theater layout, setup, preoperative imaging, postoperative immobilization, and the preference for wet or dry scopes. Since the tour is not industry sponsored, different wrist towers, finger traps, cameras, arthroscopy stacks, shavers, and instruments were all demonstrated.

Table 1 Wrist arthroscopy tour 2014

Day	City	Hospital	Surgeon	Procedure
1.	Lyon	Clinique du Parc	Dr. Christophe Rizzo	Arthroscopic repair of foveal detachment of the TFCC
				ADCLR treatment of chronic SL ligament tear
2.	Lyon	Edouard Herriot Hospital	Prof. Guillaume Herzberg	ECTR
				Arthroscopic DWG resection
				ECTR
				Arthroscopic resection of radio-volar trapezium osteophyte
		Clinique du Parc	Dr. Jérome Garret	Arthroscopic DWG resection
				Arthroscopic radial styloidectomy
				Arthroscopic resection of the scaphoid proximal pole (small fragment) due to avascular necrosis following scaphoid nonunion
3.	Paris	Clinique Jouvenet	Prof. Christophe Mathoulin	Hammock ligamentoplasty for treatment of first CMC joint arthritis
				ADCLR and arthroscopic TFCC suture
				ADCLR and arthroscopic TFCC suture
				Arthroscopic wrist arthrolysis + arthroscopic wafer resection of the distal ulna
				Arthroscopic repair of foveal detachment of the TFCC
4.	Reims	Polyclinique Saint André	Dr. Xavier Martinache	Arthroscopic radial styloidectomy
				Arthroscopically assisted ORIF of distal radius fracture
			Dr. Jean Michel Cognet	ADCLR treatment of chronic SL ligament tear
				Arthroscopic DWG resection
5.	Paris	Centre Médico-Chirurgical Paris V	Dr. Didier Fontes	WA + SL and LT ligament thermal shrinkage
				Arthroscopic repair of foveal detachment of the TFCC (”all inside“ technique)
				Arthroscopic VWG resection
				WA + debridement of TFCC central perforation
			Dr. Philippe Roure	Arthroscopic DWG resection
				WA + SL and LT ligament thermal shrinkage
				Arthroscopic TFCC suture

Abbreviations: ADCLR, Arthroscopic dorsal capsuloligamentous repair; CMC, carpometacarpal; DWG, dorsal wrist ganglion; ECTR, endoscopic carpal tunnel release; LT, lunotriquetral; ORIF, open reduction with internal fixation; SL, scapholunate; TFCC, triangular fibrocartilage complex; VWG, volar wrist ganglion; WA, wrist arthroscopy.

Our hosts were all happy to answer questions and share pearls of wisdom on a variety of subjects. They were unified in their enthusiasm for arthroscopy and willingness to teach. We all benefited from the opportunity to discuss techniques, difficult cases, and technical tips both with the experts and one another. We enjoyed truly international fellowship, often over delicious meals in very pleasant surroundings; Lyon, Reims, and Paris are beautiful in spring, and the TGV rail service made traveling simple.

The week was both enjoyable and inspirational. We would like to sincerely thank all our hosts and their staff and everyone who welcomed us into their hospitals. We would strongly encourage anyone with an interest in developing their arthroscopic skills to apply for future tours.