The Magic Arthroscope

  Arthroscopic techniques originated in Japan in the early 19th century and have made great strides in the United States since the 1880s. It is mainly used to treat various sports injuries within the knee joint, such as meniscal injuries, ruptured anterior cruciate ligaments, and early stages of osteoarthritis.  Arthroscopic surgery is generally performed by making 3-4 small 5mm holes and inserting a mirror thinner than the head of a chopstick, through which the joint is examined, and then surgical instruments of the same thickness are inserted to release the lesion. Compared to traditional surgery, this procedure is less traumatic, has a faster recovery, and a shorter hospital stay. Knee injuries of outstanding athletes internationally are generally treated by arthroscopy, with 2-3 million knee off-screen surgeries per year across the United States and 120,000 cases per year in China.  For a long time, due to the special characteristics of the bone and joint in terms of anatomical structure, physiological function and pathological changes, there are many difficulties and problems in the traditional examination and treatment methods for their injuries and diseases. For example, conventional radiographs, arthrography, ultrasonic testing, and new technologies such as computerized scanning (CT) or magnetic resonance imaging (MRI), all have a limited display range and indirect or distorted images, making the accuracy of diagnosis low and sometimes even misdiagnosed. In addition, the surgical treatment method of arthrotomy is very traumatic, and the postoperative joint adhesions are not very satisfactory, and there are more sequelae.  Since the application of arthroscopy in clinical practice, significant changes have occurred within the field of joint surgery. Through direct observation and surgical operations under direct arthroscopic vision, not only has the method of diagnosis improved and the accuracy rate increased, but also, because it is a minimally invasive procedure under the scope, the surgical results are better and there are fewer complications and sequelae. At present, the application of arthroscopy has been rapidly expanded from the original knee joint to shoulder, elbow, wrist, hip, ankle and other joints, becoming an important examination and diagnosis method and treatment means in the work of joint surgery.  To diagnose joint trauma or disease, a qualified orthopedic surgeon should do a detailed examination and physical examination, aided by X-ray if needed. When the diagnosis cannot be confirmed by the above methods, the orthopedic surgeon can perform a detailed examination through arthroscopy or further arthroscopy-assisted surgery.  Because arthroscopes are designed with different diameters, theoretically most joints can be operated arthroscopically. However, the most common joints that undergo arthroscopic surgery are the knee, shoulder, elbow, wrist and ankle.  The following problems are commonly detected by arthroscopy: (a) Inflammation: Synovitis of the joint, arthritic lesions of the cartilage.  (ii) Trauma : both acute and chronic; shoulder: rupture of the rotator tendons, impingement syndrome of the acromion and habitual dislocation. Knee: chondromalacia, rupture of the semilunar cartilage and damage to the anterior and posterior cruciate ligaments. Elbow and ankle joints: breakdown of cartilage and arthritic lesions.  (iii) Breakage of articular cartilage and joint rats : These broken tissues or fragments can become repeatedly inflamed with the joint under the activities of daily life and further cause persistent fatigue and limitation of joint movement.  With the aid of arthroscopy, orthopedic surgeons can help patients with cruciate ligament damage to reconstruct and replace the cruciate ligament and repair or remove the broken meniscal cartilage. Some workers have formed bone spurs in their elbow joints due to long term heavy work, which causes the elbow joints to be unable to be straightened and painful.