Orthopaedic surgery was practised in ancient Rome but limited for centuries. More recently, new technologies have vastly increased the scope of joint surgeons. One reason that progress in this discipline remained slow for so long was the lack of practical diagnostic tools.
Practitioners had to rely solely on verbal input from their patients, visible symptoms like swelling and inflammation, and anything else they could detect with some skilful prodding. This relatively limited approach can be sufficient when treating simple fractures or dislocations, but additional precise details are often essential when dealing with more covert bone injuries or diseases.
The first major diagnostic breakthrough for joint surgeons and medicine as a whole was the discovery of X-rays and the unprecedented ability to view previously hidden details of the skeletal system. X-ray image quality has vastly improved, and lower radiation levels ensure better patient and operator safety.
However, interpreting an X-ray Image takes a trained eye, and findings are often equivocal. The only way to examine a joint thoroughly remained to fully expose it until a new invention showed clinicians that peeping through a keyhole can have many advantages over opening a door.
Arthroscopy marked a new era for joint surgeons
Orthopaedic specialists had long rejected the value of endoscopy until a Japanese professor modified a cystoscope, a tube-like device usually used to explore the bladder, and inserted it into a knee joint. His pioneering actions subsequently led to two innovative applications still used by orthopaedic specialists today.
- Explorative surgery: What began as a simple illuminated tube has evolved into a sophisticated instrument, employing lenses and fibre optics to illuminate a joint’s interior and transmit images directly to an observer or video monitor. Today, the arthroscope offers surgeons a minimally invasive option to assess joint damage and plan appropriate interventions.
- Keyhole surgery: Following the initial small incision to identify a problem, the logical next step was to make a few more tiny openings for instruments and fix it. Today, joint specialists regularly use the arthroscopic approach to repair tendons, muscles and cartilage in the knee, hip and shoulder. The technique reduces the risk of infection and bleeding and shows faster recovery times compared to open procedures.
Specialist joint surgeons routinely replace damaged joints
Attempts by surgeons to replace damaged or diseased parts in the knee with prosthetic components date from the late 19th century. However, although their surgical techniques were sound enough, their efforts were only briefly successful at best. The problem was not skills but materials, and it has since been overcome with more robust options like titanium, polyethylene, and ceramics, creating prosthetic joints with a lifespan of as much as 20 to 30 years.
In the US alone, almost 800,000 knee replacements and more than 450,000 hip transplants are performed annually. Furthermore, many orthopaedic surgeons now use keyhole surgery to conduct these life-changing procedures.
Joint surgeons in Pretoria treating patients worldwide
Pretoria’s Wilgers Life Hospital operates an orthopaedic unit led by arthroscopy and arthroplasty specialist Dr Jan de Vos. The unit has become a preferred destination for local and international patients seeking advanced orthopaedic interventions, including robot-assisted arthroplasty. Please don’t hesitate to contact us if you should require expert hip, knee or shoulder surgery.