Knee Arthroscopy

How it began

Arthroscopy was born from the desire to "look inside" the joint without opening it fully. The first attempts appeared in the early 20th century — Eugen Bircher in Switzerland and Kenji Takagi in Japan pioneered the use of optical instruments to examine the knee. But it was Masaki Watanabe, in the 1950s–60s, who developed the first truly practical arthroscope (the famous "No. 21"), paving the way for the modern technique. From the 1970s–80s, the miniaturisation of cameras and instruments made arthroscopy the standard in knee surgery.

What it involves

Arthroscopy is a minimally invasive operation. Through two or three small incisions (a few millimetres), the surgeon introduces:

• an arthroscope — a thin camera connected to a screen that magnifies and lights the inside of the joint;
• specific instruments — to repair, suture, remove or reshape tissues;
• sterile fluid, which expands the joint and improves the view.

The surgeon views the inside of the knee in real time, in great detail, and treats the problem through the same route. It is often day-case surgery (discharge the same day), performed under regional or general anaesthesia.

Advantages

• Small incisions — less tissue trauma and minimal scarring.
• Less pain afterwards and usually a faster recovery.
• Superior visualisation — magnification allows precise diagnosis and treatment of injuries hard to see with the naked eye.
• Day-case surgery in most cases.
• Lower infection risk compared with open surgery.
• Diagnostic and therapeutic — confirms the problem and treats it in the same procedure.

What arthroscopy treats

Knee arthroscopy is used to treat, among others:

• meniscus injuries (repair or partial meniscectomy);
• anterior cruciate ligament (ACL) reconstruction;
• cartilage injuries;
• removal of loose bodies, plicae and treatment of synovitis;
• patellar instability.