Arthroscopy joint by a portal on the outer border of the patella. It is not clear if these examinations were of deceased or of living patients. Pioneering work began as early as the 1920s with the work of Eugen Bircher. He published several papers in the 1920s about his use of arthroscopy of the knee for diagnostic purposes. After diagnosing torn tissue, he used open surgery to remove or repair the damaged tissue. Initially, he used an electric Jacobaeus thoracolaparoscope for his diagnostic procedures, which produced a dim view of the joint. Later, he developed a double-contrast approach to improve visibility.
Arthroscopy during the 1970s and 1980s. Arthroscopy surgical skills have been traditionally taught in cadaver labs, although the progression to in vivo operations varies from country to country. The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) holds a list of approved courses for gaining surgical skills. A new teaching technique uses medical simulation as an alternative to cadaver training. High fidelity simulators range from those that use real surgical tools and passive haptics, such as VirtaMed's ArthroS™, to those that rely on active haptic feedback, such as the Arthro Mentor™ from Simbionix. When studied, passive haptics have