Memories of the early days of arthroscopy

To become aware of the existence of a new field a f l a s h l i s a very rare opportunity in the life of a scientist. If this awareness leads to some valid conclusions, we then call it Such creative and pioneer works on arthroscopy were carried out very early by Eugen Bircher (1), Philip H. Kreuscher (2), Michael S. Burman (3), and Kenji Takagi (4,5). Eugen Bircher (1882-1956; Fig. 1) of Switzerland made the first report on arthroscopy in 1921. He examined the meniscus of the knee joint with a Jacobaeus laparoscope using oxygen or nitrogen gas for dilating the joint cavity. But he could not continue his arthroscopic study after 1922. Strange to say, no one knew of his work on arthroscopy when I visi ted Switzer land in 1957. Dr. Norber t Gschwend, one of Bircher's relatives and a famous orthopedic surgeon, told me in 1975 that Bircher was a chief surgeon of the Kantonspital in Aarau, Switzerland, and a politically active man. He was a member of Swiss Parliament and, what is very extraordinary, also a general of a division in military service. The fact that his work in arthroscopy was not continued was considered an inevitable consequence of his circumstances. Philip H. Kreuscher (1883-1943; Fig. 2) of the United States reported on his experience with arthroscopy in the early treatment of meniscus lesions in the Illinois Medical Journal (2). When I visited the United States about 10 years ago, I attempted to get some informat ion concerning Kreuscher's early work on arthroscopy but could learn very little about him or his work. One day last year, however, I received a letter from Dr. Ralph T. Lidge of Arlington Heights, Illinois, enclosing a detailed description of Kreuscher's life history and his work in arthroscopy. Kreuscher believed that arthroscopy would become popular and widely used in the future (18). Michael S. Burman (1896-1974; Fig. 3) of the Hospital For Joint Diseases in New York described his arthroscopic investigation on cadaver joints in 1931. He examined 100 knees, 25 shoulders, 15 elbows, 20 hips, and 3 ankles. The joint cavity was distended with water, and the arthroscope he used was 3 mm in diameter. In most cases, the findings were checked by opening the joints. However, the total outside diameter of 4.0 mm of the sheath rendered only the knee, shoulder, and