OPERATIVE ARTHROSCOPY

Bangkok--Sep 7--Corporate Public Relations Consultant (CPR) HISTORY OF ARTHROSCOPY Arthroscopy and arthroscopic surgery are among the most rapidly growing techniques developed in the new millenium because of less pain ,less hospitalization, less scar, early rehabilitation and cost effective. It had earlier been believed that the Japanese researcher, Takagi, was the first to inspect a knee through a cystoscope. In the last 25 years there has been enormous development of operative arthroscopy. Watanabe in Japan should be credited with performing the first operative arthroscopy in 1957 and for developing the No. 21 arthroscope. This definitely stimulated the rest of the world to become interested in operative arthroscopy. In 1957, Masaki Watanabe developed the No. 21 arthroscope, and we were ushered into the world of the modern arthroscope. The skill was brought to North America in the late 1960s and mushroomed rapidly into a ubiquitous procedure that is now the most commonly performed orthopedic operation in Canada and the United States. Had not the British physicist, Hopkins, invented the rod lens and had Karl Storz in Tuttlingen, Germany, not been smart enough to realize how revolutionary these optics were (the leading producers of endoscopes at that time had already rejected Hopkins' offer), operative arthroscopy would never have developed the way it has. The first diagnostic arthroscopy was performed in Thailand in early 1970 by Prof Thamrongrat Keokarn . Prof Prasit Gonggetyai and Prof Vatanachai Rojvanit was the famous world leading arthroscopist at that time , who have contributed to the development of operative arthroscopy not only upgrade in servicing but also academic . This group was call SPORTS MEDICINE section under Royal College of Orthopedic Surgeon, Thailand. They introduced the use of television into arthroscopy, and he has taught hundreds of orthopaedic surgeons how to perform operative arthroscopy. During the 1970s and 1980s, numerous skills courses were provided in universities, by the American Academy of Orthopaedic Surgeons, by the Arthroscopy Association of North America, and by private experienced arthroscopic surgeons. In this way virtually the entire orthopedic community was rapidly educated in the basic skills of the technique. Throughout this time several excellent courses also appeared in other parts of the world. However, structured education does not necessarily provide good surgeons. Also, the ability to perform a procedure does guarantee that it will be performed on the right patient at the right time Most orthopedic surgeons are responsible clinicians and have appropriately incorporated arthroscopy into their armamentarium. Royal College of Orthopedic Surgeon Thailand, Sport Medicine Section was formed in 1984 onward in response to a growing need for information and research on the technique that is now involved in approximatedly one third of all orthopedic procedures. It exists to promote,encourge,support and the development and dissemination of knowledge of arthroscopic surgery in order to improve upon the diagnosis and treatment of diseases and injuries of musculoskeletal system. New innovation of technology should be distributed to the young orthopedic surgeon to have a handful skill not just in Bangkok but in provincial hospital . The comtenporary Interactive Knee Arthroscopy Work Shop, is the first hand on cardeveic workshop for arthroscopist in South East Asia. With the collaboration of Royal College of Orthopedic Surgeon of Thailand,Sports Medicine Section, and Medical Faculty ,Chulalongkorn University this course was held in Aug,28-28,2000. Each physician had performed all surgical procedures on their own cardaveric specimen with invidualized instructor. The cadeveric model was specially prepared,its characteristic were almost resemble normal human being. This kind of special technique for cadeveric preservation had been done in Thailand. Dr. Somsak Kuptniratsaikul was the Master of this Comtenporary Interactive Knee Arthroscopy Work Shop BENEFIT OUT RISK OF OPERATIVE ARTHROSCOPY As a technique, arthroscopy is continuing to expand at a rapid rate. During the 1970s the entire emphasis was on the knee. It was in this joint that basic surgical skills were honed, the use of television was developed, and operating from a television monitor rather than under direct vision was learned. In the knee, basic procedures were learned: joint inspection, removal of loose bodies, meniscectomy, meniscal repair, synovectomy, abrasion arthroplasty, simple liagament such as ACL reconstruction or complex ligament knee reconstructions,treatment of osteochondritis dissecans, and management of some fractures. As we move into the 2000, these techniques were subsequently applied to the shoulder and then to other joints. With the introduction of television as an aid to performing arthroscopy twenty years ago and with the use of the arthrospcpic surgery technique to perform procedures in the knee such as partial meniscectomy, arthroscopy grew rapidly. This growth markedly accelerated in geometric proportions owing to the increasing demands of patients who expect decreased morbidity, outpatient procedure, and more speedy return to work and to recreation. A second factor accelerating the growth of arthroscopy in the knee was the media response to the increasing use of the techniques in sports medicine. Patients saw professional athletes return to game participation in a fraction of the time previously required. However, the number of adherents grew; courses were given to teach the technique; and the orthopeadic community gradually developed a growing interest in arthroscopy because, compared with arthrotomy, arthroscopy resulted in decreased morbidity, better structural visualization of the knee, and decreased economic loss. Not only are new procedures being developed, but also techniques with new instrumentation are constantly changing. Now there is no joint in the body that has not been invaded by the arthroscope. In fact, there are more and more interesting, sophisticated procedures being developed for the elbow, ankle, wrist, temporomandibular joint, hand, foot, and even the spine. นพ. ธนา ธุระเจน พบ. (เกียรตินิยม ) Thana Turajane,M.D.(Hons) Thai Board of Orthopedic Surgery, R Spine Fellow,Cleveland Spine & Arthritis Center,Cleveland,Ohio,USA . Clinical Fellow,The Hospital For Special Surgery, (Affiliated with Cornell University Medical College),New York, NY ,USA. Office; Department of Orthopedic Surgery,Police General Hospital, Bangkok,Thailand,10300 Tel 662-2518927 Fax 662-2528080 For more information please contact Corporate Public Relations Consultant (CPR) Tel. 282-8773-4 Fax. 628-7231-2 End. -AN-