Anatomical feature of the blood supply in the repair of the meniscus of knee joint / 中国组织工程研究

ABSTRACT

BACKGROUND:The blood supply is essential for the repair of the meniscus after the suture of it in the injured knee joint. According to the condition of blood supply, the meniscus was divided into three zones by Arnoczk in 1982. The absolute vascularization zone, in which the distance to the combination part of meniscus and synovial membrane is inferior to 3mm, is called the red zone. The absolute devascularization zone, in which the above-mentioned distance is superior to 5 mm, is called the white zone.And the relative vascularization zone with the distance between 3 mm to 5mm is called red-white zone.OBJECTIVE: To observe and discuss the anatomical features of the blood supplyof the meniscus.DESIGN:Single sample observation.SETTING:Department of Orthopaedics, Huaxi Hospital of Sichuan University.PARTICIPANTS: The study was conducted in Huaxi Hospital of Sichuan University during the period from September 2000 to March 2001.Nineteen cases were collected, including 19 knees (38 menisci) from the subjects, 17 male and 2 female, whose age varied from 21 to 43 years old.All the samples were obtained in the amputation operation, the isolated limbs were without the change of re-transplantation and the voluntary donations from the non-minorities living in Sichuan.meniscus samples 7 knees (14 menisci) were taken. After the femoral artery intubation and infusion of the heparinized normal saline, the vascular bed had no blood and then was infused with the normal saline and ink of 0.5 volume fraction and the infusion pressure was 13 kPa. The infused meniscus samples underwent the dehydration of gradient ethanol,the transparency of dimethylbenzene, and preservation with ilex pedunculosa, and then the blood supply of the menisci was observed and distribution of the meniscus section 6 knees (12 menisci) with fresh and uninfused menisci were taken. The sections obtained at the sagittal plane,the coronal plane and the horizontal plane underwent hematoxylin-eosin staining. Then the tissues structure and blood supply of the meniscus samples were observed with light microscope. Another 6 knees (12meniscus) underwent the specific CD34 antibody immunohistochemical staining. Then the tissue structure and blood supply distribution of the meniscus samples were observed with the light microscope.in the devascularization zone of the meniscus.RESULTS: Nineteen cases with 38 menisci all went into the final result resourced from the medial and lateral genicular arteries and the middle genicular artery. The small vessels from them form the peripheral capillary vessel plexus and annular vessel meshwork in the synovium and joint capsule and then go into the menisci for the nutrition of the lateral The apparent lunar artery is sent by the vessel plexus around the meniscus into the body of the meniscus and arranges in the inferior,middle and superior layers and dominates 25%-30% of the zone around The vessels of the angular part of the semilunar plate cover the whole meniscus. The nutrition is supplied by the membranous synovium on the surface of the meniscus.Rich blood supply was observed in the anterior and posterior angular laminated blood supply in the body of the meniscus was newly devascularization zone of the meniscus is supplied from the joint synovial fluid is explicit.