Arthroscopy: its role in treating nontraumatic and traumatic lesions of the knee

Arthroscopy of the knee is a useful adjunct in the diagnosis and treatment of intra-articular disease. We reviewed 178 patients who had arthroscopy at Duke from November 1972 to May 1975. Anesthesia was either general or local with a block of the infrapatellar fat pad and the infrapatellar branch of the saphenous nerve. This experience demonstrated that arthroscopy was relatively rapid, increased the accuracy of diagnosis from 70% by clinical assessment alone to 96%, and influenced the management of the knee in 55% of the cases. In many instances, arthroscopy demonstrated major pathologic conditions not readily noted by prior arthrography, multiple roentgenograms, or physical examination. Arthroscopy does not eliminate the need for arthrography, although frequency of arthrography diminished as arthroscopic technics were mastered and equipment improved. Arthroscopy is valuable in the management of most knee problems. The surgeon undertaking the procedure must have adequate instruction and a wide and continued usage in order to become and remain adept.