Vascular anatomy of the human cruciate ligaments and surrounding structures

Scapinelli, Raffaele

doi:10.1002/(sici)1098-2353(1997)10:3<151::aid-ca1>3.0.co;2-x

Cited by 113 publications

(85 citation statements)

References 11 publications

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“…We are unaware of any reports describing the viability and growth of the remaining epiphysis after jointpreserving surgery. With the help of computer navigation, the epiphysis and its capsular and ligamentous attachment no longer had to be fully exposed for reference in marking the resection plane, which helped to preserve the blood supply to the remaining epiphysis [13]. This might explain the viable epiphysis in the bone scan examination and our observation that, for Patients 4 and 7, the retained blood supply supported the continuous growth of the remaining distal femoral epiphysis.…”

Section: Discussionmentioning

confidence: 99%

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Joint-preserving Tumor Resection and Reconstruction Using Image-guided Computer Navigation

Wong

Kumta

2013

Clinical Orthopaedics &Amp; Related Research

100

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Background Joint-preserving surgery is performed in select patients with bone sarcomas of extremities and allows patients to retain the native joint with better joint function. However, recurrences may relate to achieving adequate margins and there is frequently little room for error in tumors close to the joint surface. Further, the tumor margin on preoperative CT and/or MR images is difficult to transpose to the actual extent of tumor in the bone in the operating room.Questions/purposes We therefore determined whether joint-preserving tumor surgery could be performed accurately under image-guided computer navigation and determined local recurrences, function, and complications. Methods We retrospectively studied eight patients with bone sarcoma of extremities treated surgically by navigation with fused CT-MR images. We assessed the accuracy of resection in six patients by comparing the cross sections at the resection plane with complementary prosthesis templates. Mean age was 17 years (range, 6-46 years). Minimum followup was 25 months (mean, 41 months; range, 25-60 months). Results The achieved resection was accurate, with a

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Section: Discussionmentioning

confidence: 99%

“…We preserve the soft tissue and ligament attachments, in particular at the posterior intercondylar notch where the middle genicular artery enters and supplies the remaining distal femoral epiphysis [13].…”

Section: Methodsmentioning

confidence: 99%

Joint-preserving Tumor Resection and Reconstruction Using Image-guided Computer Navigation

Wong

Kumta

2013

Clinical Orthopaedics &Amp; Related Research

100

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“…[1][2][3][4] Since Hunter 5 published the first description of the blood supply to articular structures in 1743, many researchers have focused on the vascular anatomy of diarthrodial joints. The vascular anatomy of the normal ACL has been described in humans, [6][7][8] dogs, [9][10][11] ovine, 12 and rabbits. 13,14 Many studies of the ACL have described quantitative differences between the histological appearances of ACL vascular anatomy.…”

Section: Introductionmentioning

confidence: 99%

Microvascular system of anterior cruciate ligament in dogs

et al. 2006

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This study was done to investigate the microvascular system of anterior cruciate ligament (ACL) using dogs. The objective was to study the microvascular architecture and the status of the barrier function of the capillary wall in the ACL by using microangiogram, scanning (SEM), and transmission electron microscopy (TEM). The vascular system in the ACL has been intensively studied by a number of researchers, using several microangiographic techniques in dogs, rabbits, and humans. However, most of these microangiographic studies had significant shortcomings, including the lack of three-dimensional observations and function of the blood-joint barrier in the ACL. In this study, the microstructure of the ACL was examined using microangiogram, SEM, and TEM. We investigated the vasculature of the ACL with SEM of vascular corrosion casts. In addition, we examined the status of the barrier function of the capillary wall in the ACL using the protein tracer horseradish peroxidase (HRP). Feeding vessels of the ligament were predominantly coming from the synovial-derived vessels originating from the synovium attached to the ligament near the tibial and femoral bone insertions of the ACL. The anterior cruciate ligament was surrounded by synovium, which had abundant vessels. The branches of these synovial vessels were penetrating into the ligament and making the intrinsic vascular network. It was also ascertained under SEM that the perivascular space around the intrinsic vessels were communicating through the intrinsic ligament fiber bundles and the mesh-like synovial membrane. The capillaries in the ACL were all of the continuous type under TEM. The protein tracer that was injected into the joint space passed through the synovial membrane and entered into the capillary lumen in the ACL, but the tracer that was injected intravenously did not appear in the perivascular space. The existence of a blood-ACL barrier does not necessarily imply the existence of an ACL-blood barrier. We think that the blood flow in the ACL is definitely affected by the status of joint fluid and these barriers of endothelium. The clinical relevance of the fine vascular anatomy of the ACL in trauma surgery is considered. This deserves further consideration. ß

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“…Die biologische Grundlage für die Meniskusrefixation bilden Studien zur Vaskularisation der Menisken [2,3,20,25]. Drei unterschiedliche Zonen werden am Meniskus unterschieden.…”

Section: Vorbemerkungenunclassified

“…Studies of the vascularity of the menisci form the biological basis for meniscal repair [2,3,20,25]. Three different meniscal zones are distinguished.…”

Section: Introductory Remarksmentioning

confidence: 99%