The arthroscope lets surgeons examine a joint’s interior without exposing it. Later, arthroscopy evolved from a diagnostic tool into a new surgical technique. Although the first use of an instrument to inspect a joint in this fashion occurred only in 1918, endoscopes of various designs had already been used to examine other bodily cavities like the bladder for over a century. A Japanese physician named Dr Kenji Takagi first adapted this technology for orthopaedic purposes.
Although his early arthroscope proved more informative than the X-ray images of that time, it was only in the mid-20th century, following the introduction of fibre optics, that the full potential of the arthroscope became apparent. It was then that an American surgeon named Michael Burman developed the triangulation technique of employing additional keyhole incisions to insert instruments and perform surgery whilst monitoring his actions with an arthroscope.
Joint pain affects millions of people worldwide, limiting their movements and eroding their quality of life. Arthroscopic surgery offers them a minimally invasive alternative to traditional open surgical procedures with their attendant risk of excessive blood loss and infection.
Some Common Applications of Arthroscopy
The adult human body has 360 joints, but only those capable of movement are prone to conditions that, apart from traumatic injury, result in pain. Those most commonly affected are the hip, knee and shoulder joints. We will now explore some of the main reasons for performing arthroscopic surgery on each.
- Knee surgery: The hinge joint in the knee is constantly exposed to intensive stress and strain, so injuries are commonplace. These include fractures, tears to the anterior cruciate ligament and meniscus and dislocated kneecaps. The knees are commonly affected by osteoarthritis, a condition in which the protective layer of cartilage on the articulating surfaces of the joint becomes eroded, allowing bone-on-bone contact. Ultimately, the only viable option is a partial or total knee replacement. It is now common practice to avoid open surgery and employ arthroscopy to perform all of these procedures.
- Hip surgery: The hip is a ball-and-socket joint that enables a broader range of movement than the hinge type, including a degree of rotation. Like the knee, it is also prone to osteoarthritis, and although less common than knee arthroplasty, hip replacements are also performed regularly to alleviate the pain and swelling. Today, orthopaedic surgeons with relevant skills and experience often employ arthroplasty to perform this procedure.
Other reasons to operate on the hip include fractures, labral tears, hip dysplasia and femoroacetabular impingement when the femoral head rubs against the acetabulum due to an anatomical abnormality.
- Shoulder surgery: Although far less frequent than knee and hip arthroscopy, estimates indicate that around 23 000 shoulder replacements are performed annually, many arthroscopically. However, the most frequent reasons to operate on the shoulder joint are rotator cuff problems, instability resulting in frequent dislocations and a torn biceps tendon.
Benefits of Arthroscopy
Compared to open surgery, arthroscopic procedures carry less risk of excessive bleeding and infections while significantly reducing recovery times. Dr Jan De Vos is an internationally acclaimed orthopaedic specialist in arthroscopic procedures. If you need more information about relief from your joint pain, don’t hesitate to contact the orthopaedic team at the Wilgers Life Hospital in Pretoria.
