From Amputation to Arthroscopy – The Evolving Role of Joint Specialists

Feb 22, 2024 | Articles, Blog

Our hips, knees and shoulders are constantly stressed as we perform our day-to-day tasks, often leading to damage and requiring help from joint specialists. Fossil evidence suggests orthopaedics began when early humans attempted to mend fractures but were frequently forced to amputate.

Little had changed by the Middle Ages when families of bonesetters took on the task and earned substantial incomes. The first ground-breaking, but ultimately unsuccessful, attempt to replace a diseased joint occurred only towards the end of the nineteenth century. However, the lessons learned and subsequent technical developments accelerated progress. Today, orthopaedic surgeons routinely perform tasks once thought impossible, transforming their patients’ lives on a daily basis.


Key Technologies That Have Empowered Joint Specialists

  • Radiography
    Before 1896, determining the extent of damage to bones and joints relied solely on input from the patient and a physical examination. However, that year saw the release of the first working X-ray machine, providing physicians and surgeons with a clearer picture of the extent of a patient’s internal injuries and improving treatment outcomes. However, those early X-rays produced somewhat indistinct negative images that require careful interpretation by an experienced radiologist.
  • Arthroscopy
    Despite X-rays, exposing the bones and joints remained the only reliable way to assess the nature and extent of damage. That all changed in 1931 when a Japanese surgeon modified an instrument normally used to look inside the bladder and inserted it through a tiny incision into the knee joint, providing an unprecedented view of the bones and soft tissues.However, the arthroscope did not remain a diagnostic tool. Innovative orthopaedic specialists soon began leveraging this new device to perform minimally invasive “keyhole” surgery. Two or three additional tiny incisions allow surgeons to insert the miniature instruments necessary to repair damaged bones, muscles, tendons and ligaments.

    The risk of infection and excessive blood loss is far less when the entire joint is not exposed, and post-operative recovery times are significantly reduced. Today, many experienced joint specialists routinely use arthroscopic surgery to perform total and partial knee replacements.

    The minimally invasive techniques for joint replacement, technically known as arthroplasty, are now frequently used to repair damage to the hip, shoulder and other joints.


Robots Could be the Future for Joint Specialists

The science of robotics has permeated many areas once considered the exclusive domain of humans. Automated machinery now assembles vehicles while supervisors look on. Driverless cars promise a new era in which accidents will be impossible, while future wars could be fought by computers. Perhaps not surprisingly, robots have now been allocated several innovative roles in the operating theatre.

However skilled and experienced surgeons may be, they cannot consistently match the precision of a well-designed machine. Although undoubtedly the most successful orthopaedic intervention, a joint replacement must be precisely aligned to ensure long-term functionality.

Doctor Jan de Vos is one of the few South African joint specialists qualified to use ROSA (Robotic Surgical Assistant) to perform total knee replacements. Software analyses details of the surgical site, and a robotic arm guides the surgeon’s movements to ensure perfect alignment and no need for revisions. Please don’t hesitate to contact us for more details of robot-assisted arthroplasty and other orthopaedic procedures undertaken at the Wilgers Life Hospital in Pretoria.