Introduction The scope of this work was to visualize the acute effect of the sutures used in the cartilage repair. The known protocol applied to the viable cartilage tissues was improved to address this problem (1). Even though the repair of mature adult cartilage is limited, the viable chondrocytes are crucial for maintaining cartilage homeostasis. As the chondrocytes remain viable post-mortem it is possible to use cartilage explants also for comparing damage caused by other surgical equipment (scalpel, coring instruments, bipolar probes etc.) by this method. We are studying the acute injury produced by the suture passage in human explants which has not been described appropriately yet. Such approach would allow choosing optimal needle size, design, and material to be used in the clinical practice. Materials and Methods It is of therapeutic importance to assess the impact of suture on tissue damage indirectly by differential live-dead staining of the tissue explants after artifical injury of cartilage. In this trial series we used cartilage from osteochondral cylinders (6mm in diameter with 10mm of vertical thickness of the subchondral bone) procured from human cadaveric donors of different age and sex. Cylinders were stored in culture medium for 24-48h at 4^οC. After inserting the needle we pulled it through the cartilaginous part of the cylinder to simulate chirurgic suture. With a vibrating blade microtome we then sliced the cylinder into 200 μm thick slices perpendicular to the direction of suture. The slices were incubated in Viability assay kit for animal cells (Molecular Probes, Eugene, OR) containing Calcein AM and Ethidium homodimer-1 for approximately 1h. Confocal images of stacks 10 μm apart were scanned. As the fluorescent signal from both dyes was strong enough to obtain quality images (with pinhole closed to 0.7 Airy Units) through averaging no deconvolution was applied. Results The first results of confocal imaging of 200 μm thick slices from human articular cartilage showed in details the volume affected by acute injury produced by varying suturing materials. High quality 3D images helped interpret surface area based results of damaged area. In case of uncertainty check if the increased area of damaged cells actually corresponds to huge amounts of damage or if it is an artifact of nonsuperimposed injury section. From image analysis we can now statistically evaluate and compare the impact of different surgery tools on the extent of damage. Using confocal imaging for damage assessment presents an advantage over classical fluorescent microscopy in the field of volumetric study.