The transition from open shoulder surgery to arthroscopic shoulder surgery represents a classic paradigm shift. In order for that paradigm shift to have occurred, the early pioneers in this discipline had to assume several burdens of their new craft: the burden of "arthroscopic identification"; the burden of developing the language of arthroscopy; the burden of disseminating arthroscopic knowledge; the burden of developing safe arthroscopic instruments and implants; and the burden of proving biomechanical and structural equivalency between arthroscopic and open constructs. Embracing these obligations, they were able to produce the paradigm shift to arthroscopic shoulder surgery through a spirited mix of depth, breadth, and tenacity, defying long odds and conventional wisdom while creating a major breakthrough in shoulder surgery.
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