Will rheumatologists ever pick up the arthroscope again?
- 29 July 2021
- journal article
- review article
- Published by Wiley in International Journal of Rheumatic Diseases
- Vol. 24 (10), 1235-1246
- https://doi.org/10.1111/1756-185x.14184
Abstract
Conditions prompting physicians and surgeons first adapting endoscopes to peer into joints were mainly the sort of synovial conditions that would concern today's rheumatologists. Rheumatologists were among the pre-World War II pioneers developing and documenting arthroscopy. The post-War father of modern arthroscopy, Watanabe, found rheumatologists among his early students, who took back the technique to their home countries, teaching orthopedists and rheumatologists alike. Rheumatologists described and analyzed the intra-articular features of their common diseases in the ’60s and ’70s. A groundswell of interest from academic rheumatologists in adapting arthroscopy grew considerably in the ’90s with development of “needle scopes” that could be used in an office setting. Rheumatologists helped conduct the very trials the findings of which reduced demand for their arthroscopic services by questioning the efficacy of arthroscopic debridement in osteoarthritis (OA) and also developing biological compounds that greatly reduced the call for any resective intervention in inflammatory arthropathies. The arthroscope has proven an excellent tool for viewing and sampling synovium and continues to serve this purpose at several international research centers. While cartilage is now imaged mainly by magnetic resonance imaging, some OA features – such as a high prevalence of visible calcinosis – beg further arthroscopy-directed investigation. A new generation of “needle scopes” with far superior optics awaits future investigators, should they develop interest.Keywords
This publication has 153 references indexed in Scilit:
- Synovial membrane immunohistology in early-untreated rheumatoid arthritis reveals high expression of catabolic bone markers that is modulated by methotrexateArthritis Research & Therapy, 2013
- Change in CD3 positive T-cell expression in psoriatic arthritis synovium correlates with change in DAS28 and magnetic resonance imaging synovitis scores following initiation of biologic therapy - a single centre, open-label studyArthritis Research & Therapy, 2011
- Synovial tissue hypoxia and inflammation in vivoAnnals Of The Rheumatic Diseases, 2010
- Synovial tissue and serum biomarkers of disease activity, therapeutic response and radiographic progression: analysis of a proof-of-concept randomised clinical trial of cytokine blockadeAnnals Of The Rheumatic Diseases, 2009
- A prospective, randomised, placebo-controlled study to identify biomarkers associated with active treatment in psoriatic arthritis: effects of adalimumab treatment on synovial tissueAnnals Of The Rheumatic Diseases, 2008
- Systemic TNF blockade does not modulate synovial expression of the pro-inflammatory mediator HMGB1 in rheumatoid arthritis patients – a prospective clinical studyArthritis Research & Therapy, 2008
- Assessment of rituximab's immunomodulatory synovial effects (ARISE trial). 1: clinical and synovial biomarker resultsAnnals Of The Rheumatic Diseases, 2007
- Characterisation of a dendritic cell subset in synovial tissue which strongly expresses Jak/STAT transcription factors from patients with rheumatoid arthritisAnnals Of The Rheumatic Diseases, 2007
- Detailed analysis of the cell infiltrate and the expression of mediators of synovial inflammation and joint destruction in the synovium of patients with psoriatic arthritis: implications for treatmentAnnals Of The Rheumatic Diseases, 2006
- A randomized, controlled trial of arthroscopic surgery versus closed‐needle joint lavage for patients with osteoarthritis of the kneeArthritis & Rheumatism, 1993