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Open Access Highly Accessed Research article

High-resolution optical coherence tomographic imaging of osteoarthritic cartilage during open knee surgery

Xingde Li1, Scott Martin23, Costas Pitris1, Ravi Ghanta1, Debra L Stamper23, Michelle Harman2, James G Fujimoto1 and Mark E Brezinski23*

Author Affiliations

1 Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Cambridge, MA, USA

2 Division of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

3 Harvard Medical School, Harvard University, Longwood Avenue, Boston, MA, USA

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Arthritis Res Ther 2005, 7:R318-R323  doi:10.1186/ar1491

Published: 17 January 2005

Abstract

This study demonstrates the first real-time imaging in vivo of human cartilage in normal and osteoarthritic knee joints at a resolution of micrometers, using optical coherence tomography (OCT). This recently developed high-resolution imaging technology is analogous to B-mode ultrasound except that it uses infrared light rather than sound. Real-time imaging with 11-μm resolution at four frames per second was performed on six patients using a portable OCT system with a handheld imaging probe during open knee surgery. Tissue registration was achieved by marking sites before imaging, and then histologic processing was performed. Structural changes including cartilage thinning, fissures, and fibrillations were observed at a resolution substantially higher than is achieved with any current clinical imaging technology. The structural features detected with OCT were evident in the corresponding histology. In addition to changes in architectural morphology, changes in the birefringent or the polarization properties of the articular cartilage were observed with OCT, suggesting collagen disorganization, an early indicator of osteoarthritis. Furthermore, this study supports the hypothesis that polarization-sensitive OCT may allow osteoarthritis to be diagnosed before cartilage thinning. This study illustrates that OCT, which can eventually be developed for use in offices or through an arthroscope, has considerable potential for assessing early osteoarthritic cartilage and monitoring therapeutic effects for cartilage repair with resolution in real time on a scale of micrometers.

Keywords:
birefringence; cartilage imaging; cartilage repair; optical coherence tomography; osteoarthritis