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Wrist arthroscopy has a rich history, drawing on contributions from around the world. Its foundation was laid in Japan with Kenji Takagi and Masaki Watanabe, who developed the arthroscope and the techniques for arthroscopy. Across several decades they advanced the optic and lighting technology, allowing the miniaturization which made wrist arthroscopy technologically feasible. A safe and standardized technique for wrist arthroscopy was evolved by Terry Whipple, Gary Poehling, and James Roth in the 1980s, and they shared this with their fellow surgeons through courses and publications. The techniques then spread across the world, leading to widespread uptake and exploration of new therapeutic possibilities. The worldwide spread of wrist arthroscopy was accelerated by the European Wrist Arthroscopy Society (EWAS), founded in 2005 by Christophe Mathoulin. The Asia Pacific Wrist Association (APWA), founded by PC Ho in 2015, also extended the progression of wrist arthroscopy. This article brings together this history and tells the global story of its development through the recollections of those involved. The manuscript includes some amazing videos of the early historical arthroscopy. There are also videos of Gary and Terry describing some of their special memories of the early politics, developments, and evolution of wrist arthroscopy.

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Tendinopathy arises from a failed tendon healing process. Current non-invasive therapeutic alternatives are anti-inflammatory in nature, and outcomes are unpredictable. The benefit of invasive alternatives resides in the induction of the healing response. A new technology that uses non-invasive monopolar capacitive coupled radiofrequency has demonstrated the ability to raise temperatures in tendons and ligaments above 50 degrees C, the threshold for collagen modulation, tissue shrinkage and recruitment of macrophages, fibroblasts, and heat shock protein factors, without damaging the overlying structures, resulting in activation of the wound healing response. Monopolar capacitive-coupled radiofrequency offers a new non-invasive choice for tendinopathies and sprained ligaments. It does not interfere with subsequent surgical procedures should they become necessary.

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PURPOSE: The goal of this study was to compare the results of open scaphocapitate fusion and revascularization with the results of arthroscopic scaphocapitate fusion and capitate pole excision. TYPE OF STUDY: Prospective randomized study. METHODS: Between April 1997 and January 2000, 16 consecutive patients (5 men and 11 women with a mean age of 31 years [range, 18 to 61]) presenting with Kienböck's disease stage IIIA and stage IIIB were randomized to either open scaphocapitate fusion and lunate revascularization (group I) or fully arthroscopic scaphocapitate fusion and capitate pole excision (group II) groups. Cannulated 3.5-mm ASIF screws were used for the purpose of scaphocapitate fixation in both groups. Operation time, hospital stay, time to fusion, range of wrist motion at final follow-up, grip strength, and return to unrestricted activities of daily living were evaluated at 33 months' follow-up. RESULTS: The mean operating time (153 v 99 minutes), hospital stay (3.6 v 2.3 days), and return to unrestricted daily activities (15 v 5.8 weeks) were shorter in group II. Average time to radiographically evident fusion was shorter in group I (7.25 weeks v 9 weeks). There was a significant increase in grip strength and in range of motion at final follow-up in both groups, and the final grip strength and range of motion was not different between the groups. There were no major complications in either group. CONCLUSIONS: Although the number of patients was small and the follow-up period was short, arthroscopic scaphocapitate fusion and capitate pole excision in stage IIIA and IIIB Kienböck's disease resulted in shorter operating time, shorter hospital stay, earlier return to unrestricted daily activities, and equal range of motion and grip strength as compared with open scaphocapitate fusion and lunate revascularization. Determination of specific surgical indications for the benefits of arthroscopic treatment of Kienböck's disease must be analyzed in larger studies.

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PURPOSE: The study goal was to determine the results of allograft anterior cruciate ligament (ACL) reconstruction in patients over 40 years old at a minimum of 24 months follow-up (mean, 59.7 months; range, 24 to 110 months). TYPE OF STUDY: Retrospective review. METHODS: The records of 57 consecutive patients (mean age at surgery, 45.0 years; range, 40.2 to 60.8 years) were reviewed retrospectively. Nine patients who had undergone either prior ACL reconstruction, extra-articular reinforcement of the intra-articular procedure, or subsequent upper tibial osteotomy were eliminated. One patient was lost to follow-up. Of the remaining 47 patients (48 knees), 29 (62%) were men, and 18 (38%) were women. Twenty-eight of the 47 study patients (60%) were available for clinical interview consisting of physical examination, radiographs, and functional testing. Twenty-seven of these patients also underwent KT-1000 measurement, and 26 underwent Biodex evaluation. The remaining 19 patients were interviewed by telephone. RESULTS: At follow-up, Lachman, anterior drawer, and pivot shift tests were 0 or 1 in 27 (96%) of 28 patients. Differences between the index and contralateral legs as measured by KT-1000 at 20 lb of force were 0 to 2 mm in 22 of 27 patients (81%) and 3 to 5.5 mm in 5 patients (19%). None had a side-to-side difference greater than 5.5 mm. Based on the International Knee Documentation Committee activity classification system, 26 (55%) of 47 patients achieved the same or higher grade of activity postoperatively as they had preinjury. CONCLUSIONS: Results of ACL reconstruction in patients over 40 compare favorably with those observed in younger patients. Age should not be a limiting factor in choosing surgical reconstruction to treat functional instability in the ACL-deficient patient.

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