Milestones in the early history of arthroscopy

Abstract

BackgroundBefore arthroscopy, an arthrotomy had to be made to make a definitive diagnosis and treat any intraarticular pathology. The purpose of this review paper was to investigate the transition from open to arthroscopic surgery. MethodsThe authors have been interested in the subject of the history of arthroscopy since the beginning of their professional careers. The three most senior authors started performing arthroscopy already in the late 1970s. During our careers, we have collected personal experiences, artifacts, scientific papers and other documents, as well as memories of conversations of fellow enthusiasts of arthroscopy. Further, for this historic review paper, we did search procedures at PubMed.gov with combinations of search terms, i.e., “((history or historic or milestones) and (endoscopy or endoscopic or arthroscopy or arthroscopic))”. Important leads were followed-up with specific searches, e.g., on important persons and equipment/inventions. ResultsPhysicians have always had a desire to examine body cavities of their patients. Some cavities are quite accessible for diagnostic purposes, using specula and light, while others are difficult to inspect. This is where the endoscope comes into play. The female bladder was the first organ to be examined using an endoscope, by Philipp Bozzini in 1806. Whereas the urologists immediately embraced the idea of endoscopy, the orthopaedic surgeons were reluctant. The first arthroscopy was performed by Severin Nordentoft in 1912. In this paper, we focus on some important milestones in the early history of endoscopy generally and later, arthroscopy specifically. Our story ends in the 1970s with the introduction of the modern arthroscope with rod lenses, a fibreoptic light cable connected to an external light source and a live video camera connected to a monitor. ConclusionToday, arthroscopic surgery is generally regarded as one of the most important innovations in orthopaedic surgery, together with joint replacement and internal fixation of fractures. The benefits of arthroscopy include minimally invasive surgery with low morbidity, early mobilization and the ability to perform surgery as an outpatient procedure. We document some important milestones and important figures on the thorny path from open surgery to the adoption of the arthroscope as a useful orthopaedic tool. Level of evidenceLiterature study, Level IV.