Arthroscopic Surgery
A one year R. Samuel McLaughlin Foundation Scholarship, obtained in 1964, enabled Jackson to study anywhere in the world, with the promise to return to Toronto in an academic capacity. The concept was similar to cross-pollination, bringing new ideas to the Toronto School of Medicine. Tokyo, and the summer Olympic Games, was an appealing site for six months of this Scholarship, with the second six months being in research at Massachusetts General Hospital in electron microscopy. Arrangements were made to study tissue culture techniques at Tokyo University, and to assist the medical staff of the Canadian Olympic team at the Games. A secondary goal was to find a surgeon in Tokyo, that was reported to be looking inside knee joints, and had presented his preliminary work at a meeting in Barcelona two years earlier. That man was Dr. Masaki Watanabe, but he was not well known, even in his own city. One orthopaedic resident however, suggested that he might be at the Tokyo Teishin (Postal) Hospital.
On finding him, Dr.Jackson’s world changed. Watanabe was a gracious host and teacher, showing Jackson everything, in two operating sessions every week. In return, Jackson taught him English, for several hours after each arthroscopy session.(ref) On leaving Japan, Jackson bought a # 21 Arthroscope, and had it shipped back to Toronto, to be ready for use when he returned from Boston.
Soon, word was out, that you really could see pathology inside the joint, and the diagnostic guesswork associated with knees problems was largely eliminated. Other surgeons started coming to Toronto to learn the technique, and Jackson was invited to speak at many centers, and to give the first Instructional Courses in Arthroscopy at the annual AAOS meetings . Informal discussions with others interested in arthroscopy, took fruit in 1974 when the International Arthroscopy Association was founded in Philadelphia, with Dr. Watanabe being elected President, and Jackson Vice-President.(ref) The goals of the Association were teaching and research, which has persisted to the present. The success of arthroscopic knee surgery has brought about a true revolution, in all branches of Surgery, which is now called Minimally Invasive Surgery. (several refs) and reference to Sports Illustrated.
Jackson was one of the first to see and report partial and isolated tears of the anterior cruciate ligament (ACL), to describe the syndrome of the “pathologic plica”, and to promote lavage as a treatment for osteoarthritis. Many clinical studies were done in an effort to explain the observed beneficial effect of decreased symptoms after “lavage and Irrigation” (washing) of the osteoarthritic (O/A) knee. The beneficial effects were disputed by some authors, but most arthroscopists agreed that this was a very effective treatment,( although not a cure), if applied to early cases of O/A. (refs) Efforts were therefore made to help doctors think of O/A as a spectrum of degeneration, rather than a condition that is only diagnosed when joint spaces are lost, osteophytes are present and subchondral bone thickening is apparent.
Selected Arthroscopy Papers
* Jackson RW, Abe I. The role of arthroscopy in the management of disorders of the knee. An analysis of 200 consecutive examinations. J Bone Joint Surg Br. 1972;54:310–322.
* Jackson RW, Parsons CJ. Distension-irrigation treatment of major joint sepsis. Clin Orthop. 1973;96:160–164. [PubMed]
* Jackson RW. The role of arthroscopy in the management of the arthritic knee. Clin Orthop. 1974;101:28–35. [PubMed]
* Dandy DJ, Jackson RW. The impact of arthroscopy on the management of disorders of the knee. J Bone Joint Surg Br. 1975;57:346–348. [PubMed]
* Dandy DJ, Jackson RW. Meniscectomy and chondromalacia of the femoral condyle. J Bone Joint Surg Am. 1975;57:1116–1119. [JB&JS]
* Jackson RW, Dandy DJ. In: Arthroscopy of the Knee. New York: Grune & Stratton; 1976. (Text Book)
* Jackson RW, Rouse DW. The results of partial arthroscopic meniscectomy in patients over 40 years of age. J Bone Joint Surg Br. 1982;64:481–485. [JB&JS]
* Jackson, R.W., Marshall, D.J. & Fujisawa, Y.: The Pathological Medial Shelf. Clinical Orthopaedics of North America, Vol. 13: No. 2, 12, April 1982
* Northmore-Ball MD, Dandy DJ, Jackson RW. Arthroscopic, open partial, and total meniscectomy. A comparative study. J Bone Joint Surg Br. 1983;65:400–404. [JB&JS]
* Ogilvie-Harris DJ, Jackson RW. The arthroscopic treatment of chondromalacia patellae. J Bone Joint Surg Br. 1984;66:660–665. [JB&JS]
* Jackson, R.W.: Memories of the Early Days of Arthroscopy: 19651975. The Formative Years. Arthroscopy: The Journal of Arthroscopic & Related Surgery. Vol. 3: No. 1, 13, 1987 [ResearchGate]
* Frank C, Jackson RW. Lateral substitution for chronic isolated anterior cruciate ligament deficiency. J Bone Joint Surg Br. 1988;70:407–411. [JB&JS]
* Jackson RW. Septic arthritis. In: Ewing JW, editor. Articular Cartilage and Knee Joint Function—Basic Science and Arthroscopy. New York: Raven Press; 1990. pp. 191–196.
* Jackson RW. History of arthroscopy. In: McGinty JB, Caspari RW, Jackson RW, Poehling GG, editors. Operative Arthroscopy. New York: Raven Press; 1991. pp. 1–4.
* Jackson RW, Reed SC, Dunbar F. An evaluation of knee injuries in a professional football team—risk factors, type of injuries, and the value of prophylactic knee bracing. Clin J Sport Med. 1991;1:1–7.
* Jackson RW. The role of arthroscopy in patello-femoral arthritis. In: Fox JM, DelPizzo W, editors. The Patello-Femoral Joint. New York: McGraw-Hill; 1993. pp. 273–277.
* Jackson RW. The torn ACL: natural history of untreated lesions and rationale for selective treatment. In: Feagin JA Jr, editor. The Crucial Ligaments. 2nd ed. New York: Churchill Livingstone; 1993. pp. 485–493.
* Jackson RW, Gilbert JE, Sharkey PF. Arthroscopic debridement versus arthroplasty in the osteoarthritic knee. J Arthroplasty. 1997;12:465–469. [PubMed]
* Jackson RW. Technique of purse-string patellectomy. Techniques in Orthopaedics. 1997;12(3)
* Jackson RW. Arthroscopic surgery and a new classification system. Am J Knee Surg. 1998;11:51–54. [PubMed]
* Jackson, R.W.: From the scalpel to the scope: the history of arthroscopy. Baylor University Medical Center Proceedings. Vol. 9, No. 4, 7-79, 1996
* Jackson, Robert W.: Osteoarthritis of the Knee: Introduction and Overview of Treatment. The American Journal of Knee Surgery, Vol 11, No 1, 39-41, 1998 [PubMed]
* Jackson RW. Quo venis quo vadis: the evolution of arthroscopy. Arthroscopy. 1999;15:680–685. [Journal]
* Jackson RW. Arthroscopy and arthroscopic surgery. In: Klenerman L, editor. The Evolution of Orthopaedics. London: Royal Society of Medicine Press; 2001.
* Jackson, Robert W.: Letter to the Editor "Arthroscopic Surgery for Osteoarthritis of the Knee" N Engl J Med, Vol 347, No 21, pg 1717, November 21 2002
* Jackson, Robert W. & Dieterichs, Chad: Result of arthroscopic lavage and debridement of osteoarthritic knees using the degree of degeneration as a guide to treatment - a prospective study. J of Arthroscopy, Vol 19, No 1, pg 13-20, January 2003
* Kieser, C.W. & Jackson, R.W.: Eugen Bircher (1882-1956): The First Knee Surgeon to Use Diagnostic Arthroscopy. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol. 19, No. 7, 771 -776, September 2003 [PubMed]
