Vascularity of the meniscus is the most important key to meniscal tear healing. However, blood supply to the meniscus is limited to approximately the outer 10% to 25% of the meniscus, known as the “red-red zone.” The cyanine dye indocyanine green (ICG) is commonly used as a contrast imaging agent for visualizing vascularity in several medical fields. Moreover, ICG fluorescence-guided surgery is a modern trend in the field of laparoscopic surgery in which the characteristic of fluorescence enhancement under a near-infrared light is used. However, ICG fluorescence-guided knee arthroscopy findings remain unknown. In this technical note, the author applied ICG fluorescence-guided surgery to knee arthroscopy to evaluate blood supply to the meniscus and intra-articular apparatus. Additionally, the arthroscopic findings of ICG fluorescence-guided knee arthroscopy for degenerative tears of the medial meniscus before and after meniscal repair are presented. Through the intravenous injection of ICG solution, real-time detection of fluorescence may contribute to investigating case-specific vascularization of the meniscus during arthroscopy in the next generation.

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