Laser scanning confocal arthroscopy of a fresh cadaveric knee joint

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Laser scanning confocal arthroscopy of a fresh cadaveric knee joint C.W. Jones, B.Eng. (Hons.), B.Com., D. Smolinski, B.Eng. (Hons.), C. Willers, B.Sc. (Hons.), M.(Med.)Sc., P.J. Yates, M.B.B.S. (Hons.), B.Sc. (Hons.), M.R.C.S., F.R.C.S., A. Keogh, M.B.B.S. (Hons.), B.Sc. (Hons.), D. Fick, M.B.B.S. (Hons.), B.Sc. (Hons.), T.B. Kirk, Ph.D., B.Eng. (Hons.), M.H. Zheng, Ph.D., D.M., F.R.C.Path. Osteoarthritis and Cartilage Volume 15, Issue 12, Pages 1388-1396 (December 2007) DOI: 10.1016/j.joca.2007.05.003 Copyright © 2007 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Joint mapping protocol. The knee joint is divided into three areas (femoral condyles, tibial plateau and patella), and 47 individual sectors. Image adapted from the ICRS Cartilage Evaluation Package [www.cartilage.org]. Osteoarthritis and Cartilage 2007 15, 1388-1396DOI: (10.1016/j.joca.2007.05.003) Copyright © 2007 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 OA grades (I–IV) from ICRS, LSCA and modified-Mankin histological assessment for the femoral condyles, tibial plateau and patella. OA grading of (A) femoral condyle sectors, (B) patella sectors and (C) tibial sectors. Both condylar and tibial cartilage were generally Grade II OA, while patella cartilage was mainly Grade III OA. Osteoarthritis and Cartilage 2007 15, 1388-1396DOI: (10.1016/j.joca.2007.05.003) Copyright © 2007 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Healthy and OA (Grades I–II) histology compared to LSCA imaging of corresponding region. (A) H&E histology (40×) and (B) LSCA imaging of native healthy AC, demonstrating paired chondrocytes (PC) uniformly distributed in the superficial zone. (C) H&E histology (40×) and (D) LSCA imaging of Grade I OA with CC and increased cellular density. (E) H&E histology (40×) and (F) LSCA imaging of Grade II OA demonstrating surface fibrillation, loss of uniform cellular distribution, low cell density and large clumped clusters (LC) of chondrocytes. LSCA imaging illustrated the predominance of large chondrocyte clusters in the superficial zone. Note: LSCA images are XY slices (i.e., coronal) vs XZ histology (i.e., cross-sectional), dark shadows in lower left quadrant are image artefacts as a result of lens marking. Osteoarthritis and Cartilage 2007 15, 1388-1396DOI: (10.1016/j.joca.2007.05.003) Copyright © 2007 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 Healthy and OA (Grades III–IV) histology compared to LSCA imaging of corresponding region. (A) H&E histology (40×) and (B) LSCA of Grade III OA, demonstrating severe surface fibrillation, deep cartilage fissuring (F) with clustered chondrocytes, and reduced cellularity visible. (C) H&E histology (40×) and (D) LSCA of Grade IV OA, with complete disruption of normal chondral architecture and almost total loss of chondrocytes apart from sparse clustering. LSCA imaging illustrates the gross fibrillation and mostly acellular nature of the cartilage surface. Osteoarthritis and Cartilage 2007 15, 1388-1396DOI: (10.1016/j.joca.2007.05.003) Copyright © 2007 Osteoarthritis Research Society International Terms and Conditions