By Jill Renee

Phillipe Bozzini in the year 1806 was the first doctor who presented a device with which it was possible to illuminate and view a natural cavity, but only in 1853 had Desormeaux developed an optical system with mirrors which allow them to light the bladder through an external light and observe it. This device was named by him the endoscope and it allowed him to carry out an observation technique that became known as endoscopy. The first use of an endoscope to observe a joint cavity dates back to 1918 when the Japanese doctor Takagi first explored the knee, thus becoming the pioneer of arthroendoscopy, which later changed its name, for simplification, to arthroscopy, just as the endoscope received the more specific name of arthroscope. Arthroscopy is therefore by definition, the observation through an optical system (endoscope) of a joint cavity.

Many have been the advances in arthroscopy, or in the creation and improvement of their instruments, either in the development of techniques of use, which allow the visualization of the joint to proceed with purely diagnostic purposes (diagnostic arthroscopy) or for the ability to perform surgical procedures (surgical arthroscopy). Geist was one of the pioneers in 1926 to hold the first synovial biopsy and Watanabe was his follower, in 1962, being the first orthopedist to deal with this technique for a meniscal lesion.

Currently arthroscopy is performed by means of a sophisticated sound system that includes an optical lens surrounded by bundles of optical fibers (arthroscope) which allows driving into the joint, a light generated externally (by a cold light source) and both image capture and the intra articular introduction or aspiration of fluid from the joint cavity. To this device, which has a diameter of around 4 mm, is attached a mini video camera that transmits the captured image, reproducing it on a video monitor. This system has an integrated scanner which allows image recording and the archiving of images. In addition to this equipment, there is used a complex set of instruments or apparatus, including a motor, which is adapted to perform the different techniques. Also the number of joints that could be observed and treated in this way has been progressively extended, evolving from the knee to the shoulder, elbow, the tibio-tarsal, wrist, and, in theory, all of the joints.

The development of instrumental and technological developments in the field of the miniaturization of optical systems and video allows for a large capacity of intra articular visualization, and has made diagnostic arthroscopy a surgical technique, thanks to the excellent image quality obtained, with an accurate diagnosis and having the possibility for numerous surgical procedures, thanks to the quantity and effectiveness of the available instruments. Currently arthroscopic surgical procedures take place increasingly, for a growing number of joints, particularly in the joints of small size, for example, the hand, which also uses smaller instruments. By their frequency of occurence, the knee stands out, for the treatment of meniscal tears, anterior cruciate ligament reconstructions, the removal of loose bodies and the treatment of articular cartilage lesions.

About the Author: Jill Renee writes extensively on medical issues and recommends visiting this

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