Learning arthroscopy requires orthopaedic surgeons to master a series of complex tactile and cognitive skills. An example of the latter is the ability to perceive the structures of the joint through the two-dimensional view through the arthroscope This has been described as placing one’s eye at the tip of the arthroscope within the joint cavity. This is especially challenging as one’s perspective changes according to the characteristics of the instrument such as focal length, field of view, and direction of view.
Photography and video equipment formed an essential basis for early arthroscopy. Its importance only increased as technology improved and the video screen replaced the eyepiece as the arthroscopist’s primary window. Arthroscopic atlases were also indispensable as they assisted orthopaedic surgeons in developing the ability to distinguish the normal from the abnormal through the arthroscope’s tiny perspective.
An Orthopedic Surgeon (likely Dr. Masaki Watanabe) preparing an arthroscopic photograph using the Watanabe 21 arthroscope and the adapted Olympus Pen 35 mm camera. (Watanabe 1978, 42)
Camera for Watanabe Type No. 21 Arthroscope (c. 1960s)
Many of the early arthroscopic photographs were produced by this camera, which was adapted for use with the Watanabe 21 Arthroscope.
This is an Olympus-Pen F 35 mm half-frame film camera. It features an adapter for mounting the Watanabe arthroscope in place of the shutter release. It also features a mechanism that is linked to the shutter release that temporarily doubles the voltage to the arthroscope’s tungsten lamp in order to produce sufficient illumination to expose the film. The brightness of this lamp proved one advantage over newer fiber optic illuminators for the purpose of photography.
Film photography in arthroscopy proved a special challenge. Since different parts of the knee’s anatomy have different reflective properties, they require different exposure settings.
Atlas of Arthroscopy/ Atlas de Artroscopia (1980)
“Fig 55-a Case of advanced rheumatoid arthritis with marked proliferation of the villi and adhesions, some of which are fibrinous, of the synovial membrane. The joint space is reduced.” A photograph taken with the Watanabe 21 and its adapted camera, published in the Atlas of Arthroscopy/ Atlas de Artroscopia (1980).
Published in 1980 by a group at the General Hospital in Mexico City, this atlas is a good example of the images that the Watanabe 21 and Olympus Camera produced.
This atlas is an example of the dozens of texts that were acquired by the University of Toronto along with his collection. These books have been invaluable in documenting the collection.
An Articulated Viewing Device (AVD, c. 1970s)
The AVD was developed as an optical attachment for an arthroscope that permitted a second viewer, typically a student, to share the view through the arthroscope. Unlike unarticulated instruments like the Watanabe 90° beam splitter, the articulations allowed the arthroscopist to work relatively unimpeded.
The second eyepiece could also be used for video recording. This device was designed before the widespread dissemination of relatively light CCD cameras that could easily send the arthroscopic view to a video screen. This device allowed a large video camera, typically mounted to the ceiling, to be used for recording. Even after the availability of CCD cameras, this arrangement carried some advantages.
Early Arthroscopic CCD Camera (c. 1980s)
This solid-state camera was probably kept as an early example of the type. This model was likely sold in the early 1980s as CCD technology was entering the field of arthroscopy. This was just the latest in several generations of ever-smaller video technologies applied to endoscopy. While their low mass was a major advantage when coupled to the arthroscope’s eyepiece, early CCD cameras were relatively grainy and had lower resolution compared to contemporary video tube cameras.
Without the relevant trade literature such as journal advertisements or sales pamphlets, such material can be difficult to date precisely. Syn-Optics was acquired by Stryker in 1981.