The Watanabe Club was founded in 2003 as an informal forum for the exchange of ideas and concepts between shoulder surgeons in the developing field of shoulder arthroscopy. As in many of the subspecialty disciplines in orthopaedic surgery in the United Kingdom, the practice of shoulder surgery had evolved embracing all aspects of trauma and reconstructive surgery, including joint replacement under the auspices of the British Elbow and Shoulder Society (BESS). Unlike in continental Europe and the USA, there was no national arthroscopic society meeting in the UK on a regular basis.
At the same time, audits of the experience of orthopaedic trainees revealed that in some regions there was wide exposure to shoulder arthroscopy, both diagnostic and therapeutic, while in other regions trainees might pass through six years of training without ever seeing a single arthroscopic shoulder procedure. There were few shoulder courses offering basic instruction and it was clear that many trainees starting on a shoulder firm had never handled an arthroscope in a shoulder. Courses of advanced instruction in a few centres inspired many by what could be achieved by the great and good, but confidence in tackling complex pathology takes time to acquire and the bewildering array of anatomical variants, pathological lesions, instruments, anchors and peripheral devices proved a daunting prospect to those embarking on an arthroscopic career.
Early on in the Clubs history, it was felt that these regular meetings of members could serve a twin purpose; firstly to facilitate the provision of basic instruction in shoulder arthroscopy to trainees and consultants new to the field, and secondly through faculty dialogue to demonstrate and validate new techniques in a practical way. Using the successful model of the Swiss AO group, a series of structured courses was developed, going from the very basics (anatomy, examination, diagnostic imaging) to the principles of shoulder arthroscopy (equipment, setup, orientation, triangulation, recognition of pathology) and then progression to surgical intervention with an emphasis on practicality.
The ethos of the Club derives from the passion the faculty members share for the field of shoulder arthroscopy and the desire to pass on the wisdom of experience (what works and what doesnt) to the next generation of shoulder arthroscopists. Several principles account for the popularity and success of the Watanabe Club courses:
low delegate to faculty ratio
emphasis on practical skills
serial progression through the courses
faculty representation from all over the UK
courses held in the north and south
learning should be a positive experience
The name of the Club derives from the founder of modern arthroscopy, Dr Masaki Watanabe (1911-1995). Watanabe, working in Tokyo, was a student of Professor Kenji Takagi, who was one of the first surgeons to attempt to insert an endoscopic instrument into a joint cavity. In the early part of the twentieth century, these devices were fragile, unreliable and carried delicate tungsten glass bulbs. It took many years before the best arrangement of lenses and optics were developed, and with each successive iteration, the new scopes were given a consecutive number. Although this pioneering work was interrupted by World War II, finally in 1958 Watanabe created the no. 21 arthroscope which proved durable, practical and workable. In 1975 Watanabe was a founding member of the Japanese Arthroscopy Association and in 1983 was awarded the Asahi Prize, the highest honour for science in Japan.
In the early 1960s the late Dr Robert Jackson from Toronto, Canada visited Dr Watanabe in Tokyo and was encouraged by his findings. He brought a no. 21 arthroscope back to North America, promoted Watanabes work and in doing so revolutionised the treatment of joint injuries and conditions throughout the world. In 1998, Andrew Wallace, one of the founding members of the Watanabe Club, undertook a fellowship in Calgary, Canada with Dr Cyril Frank, who had formerly been a fellow of Dr Jackson. During that year Dr Jackson visited Calgary and inspired Andrew develop a career in shoulder arthroscopy, and through this connection a link exists between the Club and its namesake.
Expanding the scope of the Club has always been a priority. The members welcome informal visits to their own hospitals and units from course alumni, and have established, with their own funding, the Watanabe Travelling Fellowship to provide a bursary to enable aspiring shoulder arthroscopists to see skills and techniques in action. Shoulder 2 Shoulder: A Search for Consensus in Shoulder Arthroscopy is a concept that was developed by Susan Alexander, a North West Thames orthopaedic trainee and Watanabe faculty member, to return to the original aims of the club of promoting and advancing knowledge amongst enthusiastic and passionate arthroscopic shoulder surgeons. The conference, held biennially in London, provides a forum for discussion of controversies and conundrums in this rapidly evolving field.
While the Watanabe Club is a non-affiliated, free and open forum that aims to meet the needs of the members and delegates attending the courses, it is grateful for the on-going educational support of Smith and Nephew Endoscopy, a company that has been committed to the ethos of the Club since its inception.