Indocyanine Green Fluorescence-Guided Knee Arthroscopy: A Technical Note for Investigating the Microvasculature Around the Meniscus.

Abstract

Vascularity of the meniscus is the most important key to meniscal tear healing. However, blood supply to the meniscus is limited to approximately the outer 10% to 25% of the meniscus, known as the "red-red zone." The cyanine dye indocyanine green (ICG) is commonly used as a contrast imaging agent for visualizing vascularity in several medical fields. Moreover, ICG fluorescence-guided surgery is a modern trend in the field of laparoscopic surgery in which the characteristic of fluorescence enhancement under a near-infrared light is used. However, ICG fluorescence-guided knee arthroscopy findings remain unknown. In this Technical Note, the author applied ICG fluorescence-guided surgery to knee arthroscopy to evaluate blood supply to the meniscus and intra-articular apparatus. Additionally, the arthroscopic findings of ICG fluorescence-guided knee arthroscopy for degenerative tears of the medial meniscus before and after meniscal repair are presented. Through the intravenous injection of ICG solution, real-time detection of fluorescence may contribute to investigating case-specific vascularization of the meniscus during arthroscopy in the next generation.