What is an arthroscope and what is it used for?

The arthroscope is a device used in joint-related surgery. It consists of a thin tube fitted with fibre optics, which has a light system and video camera, which records and retransmits it to the corresponding monitors. 

This device is introduced through a small incision in the affected joint in order to visualise the inside of the joint and find the anomaly that is causing the ailment.

The arthroscope is specifically designed for diagnostic and surgical use in joints, but there are variants that, using the same mechanism of lenses, light, camera and fibre optics, are used for pelvic-abdominal surgery (laparoscope) and thoracic surgery (thoracoscope), the main difference being the size of the device.

• The arthroscope allows joint surgery to be performed without the need for open surgery.
• The most common arthroscopy is knee arthroscopy, used to repair the meniscus and ligaments, although it is also used in shoulder and hip surgery, among others.
• The main advantage of arthroscopy is the reduction of recovery times and the minimisation of complications.

The use of devices for human exploration of internal organs was already known in ancient Greece. In the ruins of the city of Pompeii, instruments for vaginal exploration were found, very similar to those used today.

Around 1805, Philipp Bozinni developed the first instrument incorporating a lens reflection system that transmitted the image of the inside of the human body, accompanied by a light. This system was first tested on animals and after some improvements was tested on humans.

This device, however, was still only used for the examination of the female reproductive organs, and was operated with paraffin, which caused burns. Over the years, numerous celebrities in the medical field contributed their improvements to the system, either in illumination or image transmission.

But it was not until 1918 that Professor Kenji Takagi examined the inside of a joint for the first time. Specifically, he studied the inside of a cadaver's knee. To do this, he used a device that resembles what we know today as an arthroscope. The instrument he used was gradually modified, reducing its size and delicacy. From 1931 onwards, Finkelstein, Mayer and Burman, through independent research, obtained the first views of the inside of the knee in living patients. Burman also performed the same procedure on other major joints of the human body: shoulder, elbow, wrist, hip and ankle.

From 1974 onwards, fibre optic tubes with mini-cameras connected to external monitors began to be used. Nowadays, we still use fibre optic arthroscopes, which have been perfected to such an extent that the image quality allows us to observe the joint cavity in HD and even with 3D technology.

Arthroscopy is useful for looking inside a joint such as a knee, shoulder, ankle, hip or wrist. The procedure is simple; it consists of making an incision in the joint to introduce the arthroscope and be able to make a diagnosis or perform surgery. 

The symptoms that joint areas present when there is an abnormality are often quite difficult to diagnose (usually the problem is detected by the patient's pain, inflammation of the area and/or blockage of the joint), so an arthroscopy clarifies the clinical diagnosis or determines it. 

Arthroscopic surgery replaces conventional open surgery, and is much less invasive.

Arthroscopy is most commonly used in diagnostic and surgical procedures related to the knee, but other joints such as the shoulder, elbow, wrist, hip and ankle can also be examined. 

Some surgeries in which this technique can be used are cartilage tears, damaged joint resurfacing, ligament tears, patellar damage, arthritis, joint infections, recurrent dislocations, etc. 

The most common surgeries performed using the arthroscope are:

Surgical arthroscopy of the meniscus

This surgery consists of repairing a meniscus tear, either by suturing or removal, using an arthroscope and the surgical instruments necessary to carry out the repair. To find out step by step how the meniscus repair operation by arthroscopy is carried out, you can visit this link: Knee meniscus surgery by arthroscopy.

Cruciate ligament reconstruction by arthroscopy

This surgery consists of the reconstruction of a torn or ruptured cruciate ligament using an arthroscope, avoiding the need to open the knee in open surgery and thus reducing post-operative recovery times. 

To find out how the arthroscopic cruciate ligament reconstruction operation works step by step, please visit the following link: Knee ligament surgery by arthroscopy (cruciate ligaments).

Arthroscopy has numerous advantages over open surgery, especially in operations involving the knee. The main advantages come in relation to patient treatment and recovery.

As the surgery is carried out by making small incisions around the joint, it greatly reduces the amount of tissue involved, which results in much less inflammation of the joint and a much faster recovery for the patient, who can return to normal life almost immediately (depending on the type of work activity performed, a rest period of one or two weeks may be necessary).

The precision derived from arthroscopy makes it possible to perform extremely delicate operations that would be unthinkable in open surgery, such as partial meniscectomy with resection of the posterior horn of the internal meniscus, because while arthroscopy makes it possible to clearly visualise the affected area, in open surgery it remains a blind area that is much more difficult to manipulate.

On the other hand, arthroscopic surgery greatly reduces the complications that can occur in open surgery. In addition to complications during surgery, such as blood clots or haemorrhages, complications related to recovery are also reduced, as they generate much smaller scars that have a much lower risk of infection and leave a better aesthetic result.