Expanding the Scope beyond the Shoulder and Knee: Integrating Elbow, Wrist, and Ankle Arthroscopy into Orthopaedic Training

Jeyaraman, Naveen; ASPVS, Saketh; Murugan, Shrideavi; Nallakumarasamy, Arulkumar; Jeyaraman, Madhan

doi:10.21608/bmfj.2025.398460.2504

Expanding the Scope beyond the Shoulder and Knee: Integrating Elbow, Wrist, and Ankle Arthroscopy into Orthopaedic Training

Document Type : Review Article

Authors

¹ Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India

² Department of Orthopaedics & Sports Medicine, Yashoda Hospitals, Hyderabad, Telangana, India

³ Department of Orthopaedics, Tirunelveli Medical College and Hospital, Tirunelveli, Tamil Nadu, India

⁴ Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal, Puducherry, India

⁵ Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077

10.21608/bmfj.2025.398460.2504

Abstract

Arthroscopy, traditionally dominated by knee and shoulder procedures, has witnessed a paradigm shift with growing recognition of its utility in smaller joints such as the elbow, wrist, and ankle. These joints, though technically more challenging, are increasingly implicated in sports-related trauma, occupational injuries, and degenerative disorders. Despite this clinical demand, arthroscopy training in India continues to emphasize larger joints, often neglecting the smaller yet critical joints. This review aims to evaluate the current educational landscape for small joint arthroscopy in India and propose a roadmap for integrating structured training into orthopaedic curriculum. A systematic literature review of international training models, current Indian orthopaedic curriculum frameworks, and published data on training outcomes was conducted. Major gaps identified include absence of structured training modules for elbow, wrist, and ankle arthroscopy, limited infrastructure (such as simulators and cadaveric labs), a scarcity of skilled mentors, and inadequate clinical exposure. The review concludes that a significant transformation in orthopaedic training is urgently needed. National Medical Commission (NMC) guidelines must be revised to incorporate structured learning modules, supported by investments in simulation and cadaver-based learning, and mentorship programs. These reforms will ensure Indian orthopaedic surgeons are equipped to deliver safe and effective care for a broader spectrum of joint pathologies.

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