Open AccessIntra‐operative assessment of the vascularisation of a cross section of the meniscus using near‐infrared fluorescence imaging
Author(s) -
Schie Peter,
Lelij Thies J. N.,
Gerritsen Maxime,
Meijer Ruben P. J.,
Arkel Ewoud R. A.,
Fiocco Marta,
Swen JanWillem A.,
Vahrmeijer Alexander L.,
Hazelbag Hans Marten,
Keereweer Stijn,
Driel Pieter B. A. A.
Publication year - 2022
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-021-06690-w
Subject(s) - meniscus , medicine , indocyanine green , anatomy , medial meniscus , nuclear medicine , osteoarthritis , surgery , pathology , optics , physics , incidence (geometry) , alternative medicine
Abstract Purpose The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra‐operatively using near‐infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA). Methods The anterior horn (i.e., Cooper classification: zones C and D) of the meniscus that was least affected (i.e., least degenerative) was removed during TKA surgery in ten patients to obtain a cross section of the inside of the meniscus. Thereafter, 10 mg of ICG was injected intravenously, and vascularisation of the cross section of the meniscus was assessed using the Quest spectrum NIRF camera system. We calculated the percentage of patients in whom vascularisation was observed intra‐operatively using NIRF imaging compared to immunohistochemistry. Results Meniscal vascularisation using NIRF imaging was observed in six out of eight (75%) patients in whom vascularisation was demonstrated with immunohistochemistry. The median extent of vascularisation was 13% (interquartile range (IQR) 3–28%) using NIRF imaging and 15% (IQR 11–23%) using immunohistochemistry. Conclusion This study shows the potential of NIRF imaging to visualise vascularisation of the meniscus, as vascularisation was observed in six out of eight patients with histologically proven meniscal vascularisation. Level of evidence IV.