Vascularisation Meniscus Study.sav

<b>Background and purpose:</b> The healing capacity of the meniscus is directly related to blood supply. Therefore, high number of failure rates after meniscal repair might be reduced by only suturing tears that are localised in vascularised tissue. The aim of this study is to evaluate the feasibility of Near Infrared Fluorescence (NIRF)-imaging using Indocyanine Green (ICG) to visualise the vascularisation of the meniscus in patients undergoing a total knee arthroplasty (TKA). We determined the percentage of patients in which vascularisation in the menisci was seen using NIRF-imaging, and correlated intraoperative findings to postoperative immunohistochemistry of the meniscus. <b>Methods:</b> In 10 patients, the anterior part of the meniscus that was least affected by osteoarthritis was removed during TKA to clearly visualize the inside of the meniscus. Next, 10 milligrams of ICG was injected intravenously and vascularisation was imaged using the Quest spectrum NIRF camera system. We calculated the percentage of patients where vascularisation was seen intraoperatively using NIRF-imaging, as well as the correlation between the extent of vascular ingrowth from the peripheral margin towards the centre of the meniscus, as measured with NIRF-imaging and immunohistochemistry. <b>Results:</b> Meniscal vascularisation using NIRF-imaging was seen in 75% of the patients in whom vascularisation was demonstrated postoperatively with immunohistochemistry. The mean extent of vascular ingrowth was 16% (standard deviation (SD) 14) using NIRF-imaging and 21% (SD 13) with immunohistochemistry. A weak and non-significant correlation was estimated between extent of vascular ingrowth measured between NIRF-imaging and immunohistochemistry. <b>Conclusion:</b> This study shows the potential of NIRF-imaging to visualise the vascularisation of the meniscus during meniscal surgery. However, further arthroscopic research is needed to investigate this application for meniscal repair.