title: High-resolution optical coherence tomographic imaging of osteoarthritic cartilage during open knee surgery.
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-microm 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.
authors.affiliation: Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Cambridge, MA, USA. xingde@u.washington.edu
authors.forename: Xingde
authors.initials: X
authors.lastname: Li
authors.forename: Scott
authors.initials: S
authors.lastname: Martin
authors.forename: Costas
authors.initials: C
authors.lastname: Pitris
authors.forename: Ravi
authors.initials: R
authors.lastname: Ghanta
authors.forename: Debra L
authors.initials: DL
authors.lastname: Stamper
authors.forename: Michelle
authors.initials: M
authors.lastname: Harman
authors.forename: James G
authors.initials: JG
authors.lastname: Fujimoto
authors.forename: Mark E
authors.initials: ME
authors.lastname: Brezinski
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001718:Birefringence; D002358:Cartilage, Articular / Q000737:chemistry / Q000473:pathology*; D003094:Collagen / Q000032:analysis; D003199:Computer Systems; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007432:Intraoperative Period; D020370:Osteoarthritis, Knee / Q000473:pathology* / Q000601:surgery; D041623:Tomography, Optical Coherence / Q000295:instrumentation
chemical_list: D003094:Collagen
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