Current and Future Applications of Fluorescence Guidance in Orthopaedic Surgery

Mol Imaging Biol. 2023 Feb;25(1):46-57. doi: 10.1007/s11307-022-01789-z. Epub 2022 Nov 29.

Abstract

Fluorescence-guided surgery (FGS) is an evolving field that seeks to identify important anatomic structures or physiologic phenomena with helpful relevance to the execution of surgical procedures. Fluorescence labeling occurs generally via the administration of fluorescent reporters that may be molecularly targeted, enzyme-activated, or untargeted, vascular probes. Fluorescence guidance has substantially changed care strategies in numerous surgical fields; however, investigation and adoption in orthopaedic surgery have lagged. FGS shows the potential for improving patient care in orthopaedics via several applications including disease diagnosis, perfusion-based tissue healing capacity assessment, infection/tumor eradication, and anatomic structure identification. This review highlights current and future applications of fluorescence guidance in orthopaedics and identifies key challenges to translation and potential solutions.

Keywords: Fluorescence-guided surgery; Indocyanine green imaging; Meniscus tear; Necrotizing soft tissue infection; Nerve imaging; Tissue-simulating phantoms; Tumor imaging.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fluorescence
  • Fluorescent Dyes
  • Humans
  • Neoplasms*
  • Optical Imaging / methods
  • Orthopedic Procedures*
  • Orthopedics*
  • Surgery, Computer-Assisted* / methods

Substances

  • Fluorescent Dyes