Abstract 4

RECENT DEVELOPMENTS IN LASER SCANNING CONFOCAL ARTHROSCOPY

C W Jones¹, D Smolinski¹, D Joy¹, W McLean³, T B Kirk¹, D Wood² and M H Zheng²

¹School of Mechanical Engineering, University of Western Australia, Perth, Australia
²Department of Orthopaedic Surgery, University of Western Australia, Perth, Australia
³Optiscan, Pty. Ltd. Melbourne, Victoria, Australia

The School of Mechanical Engineering, UWA has developed a novel laser scanning confocal arthroscope (LSCA) that utilises unique fibre optic technology and has numerous potential applications in the fields of orthopaedic research and orthopaedic surgery. The need for mechanical biopsy is obviated by the LSCA's ability to generate 2D and 3D views of tissue microstructure. We have recently reported on new developments and experimental applications of the LSCA. Two major studies have recently been undertaken, the first, an in vitro Ovine study, utilised the LSCA for the characterisation of healthy muscle, tendon, menisci and articular cartilage. More recently the LSCA has been used in an in vivo longitudinal study of the progression of osteoarthritis (OA) in Ovine stifle joints.

In this first study we report on the in situ characterization of chondral and connective tissues in their unaltered physiological environment. The results of our studies demonstrate the common histological features of these tissues and demonstrate the efficacy of LSCA as a rapid method for non-destructive assessment. More recently our work has focused on using the LSCA for the detection of early osteoarthritic changes within ovine stifle joints. The model used was a bilateral lateral meniscectomy a procedure that is known to induce osteoarthritic model in the femoro-tibial joint. Preliminary results show noticeable changes from healthy cartilage to 3- week post-operative cartilage. Chondrocyte cluster formations as expected are easily visible along with fibrillations of varying degrees.

This study is unique in that it is the first time that non-destructive confocal arthroscopy has been employed in vivo for longitudinal study in an large animal model. The continuing development of laser scanning confocal arthroscope (LSCA) demonstrates its potential as a tool for assessing orthopaedic tissues in vivo thereby obviating the need for destructive tissue biopsy. The instrument has definite application in detecting early osteoarthritic changes and possibly for assessment of the efficacy of cartilage repair techniques such as Matrix Induced Autologous Implantation (MACI).

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