Will rheumatologists ever pick up the arthroscope again?

Area of Science:

• Rheumatology
• Orthopedics
• Medical Technology

Background:

• Arthroscopy's origins trace back to early 20th-century joint condition investigations.
• Rheumatologists were pivotal in developing and documenting arthroscopy before World War II.

Observation:

• Post-war advancements, notably by Watanabe, saw rheumatologists as key students, disseminating arthroscopic techniques globally.
• Rheumatologists extensively analyzed intra-articular disease manifestations in the 1960s and 70s.
• The 1990s witnessed increased rheumatologist interest in arthroscopy, spurred by the advent of office-based 'needle scopes'.

Findings:

• Rheumatologists' research influenced clinical practice, leading to trials questioning arthroscopic debridement efficacy in osteoarthritis (OA).
• Development of biological therapies reduced the need for arthroscopic interventions in inflammatory arthropathies.
• Arthroscopy remains crucial for synovial tissue visualization and biopsy, particularly in research settings.

Implications:

• Despite advancements in magnetic resonance imaging for cartilage, certain OA features like calcinosis warrant further arthroscopic study.
• Emerging high-resolution 'needle scopes' present future opportunities for arthroscopic investigation in rheumatology and related fields.