Arthroscopy – What it is and when it’s needed

Jul 27, 2022 | Articles

What is Arthroscopy, and When is it Indicated?

The centuries-long history of medicine has been one of successive technological breakthroughs that have altered its course forever. The invention of the microscope and the subsequent discovery of bacteria were followed later by the first antibiotic, revolutionising the treatment of previously incurable infectious diseases. Röntgen’s discovery of X-rays led to a diagnostic tool that impacted most medical disciplines. However, the introduction of the investigative procedure known as arthroscopy by a Tokyo professor in 1918 was the turning point for the orthopaedic specialist. So what was so special about this new technique?

arthroscopy-dr de Vos

The Value of the Invention of Arthroscopy

X-ray images were invaluable in the assessment of fractures. However, they were somewhat less helpful for studying damage to soft tissues, such as the muscles, tendons, and ligaments of the hip and knee joints. Consequently, there had been little progress in joint surgery. That changed when professor Kenji Takagi modified an instrument designed to view the interior of the bladder to peer inside the knee of a cadaver – the first recorded use of arthroscopy.

Endoscopes are now widely used in many branches of medicine. Although they may differ in size and shape, they all share the same key components. Generically, the instrument consists of a rigid or flexible tube fitted with lenses and a light source, which is inserted into a body cavity via a tiny incision. Modern devices now employ a fibre-optic cable to transmit light to the inspection site and relay full-colour, magnified images back to a miniature video camera. The surgical team can then view these on a monitor while they operate.

Although arthroscopy was first used purely for diagnostic purposes, some specialists followed the example of their peers in other disciplines. They began using the instrument to perform simple surgical procedures on damaged and diseased joints. Today, arthroscopic procedures are performed routinely in many clinics as a minimally invasive alternative to open surgery. After inserting the scope, two additional small incisions provide portals to insert and manipulate the specially designed surgical instruments required. This approach limits the risk of excessive bleeding and infections and reduces recovery times.

Some typical procedures now routinely performed on the knee using arthroscopy include repairs to a torn meniscus or cruciate ligament. The approach is also widely used to trim or reconstruct damaged articular cartilage and remove inflamed synovial tissue. However, the most significant breakthrough for orthopaedic surgeons has been the option to employ this minimally invasive approach when performing a knee replacement. In its simplest form, the technique requires removing the damaged ends of the tibia and femur and replacing them with tailored metal parts. Finally, a plastic cushion is inserted between these to ensure smooth movement.

In practice, arthroscopy is not always viable for joint-replacement surgery. However, it has proved to be a valuable alternative to open surgery when diagnosing and treating many painful conditions that affect the hip, knee, shoulder, and other joints. For the patient, it is less traumatic and less prone to complications. For the surgeon, it means undergoing specialised training in the required techniques.

The orthopaedic department of the Life Wilgers Hospital in Pretoria is a world-renowned national referral destination for patients requiring minimally invasive joint surgery. We invite you to view our patient testimonials to learn more about how arthroscopy has helped others with painful, swollen joints. Contact us for more information.