The inferior medial genicular artery and its vascularization of the pes anserinus superficialis: A cadaveric study

Autor: Lena Hirtler, Patrick Weninger, Manuel Ederer, Mike Faber
Jazyk: angličtina
Rok vydání: 2016
Předmět:
medicine.medical_specialty
Genicular artery
Anterior cruciate ligament reconstruction
knee injuries
Anterior cruciate ligament
medicine.medical_treatment
pes anserinus superficialis
vascularization MeSH terms: Anterior cruciate ligament reconstruction
03 medical and health sciences
0302 clinical medicine
vascularization
lcsh:Orthopedic surgery
medicine.artery
grafts
medicine
Orthopedics and Sports Medicine
Pes anserinus
arthroscopy
030222 orthopedics
inferior medial genicular artery
pedunculated graft
medicine.diagnostic_test
business.industry
Arthroscopy
mesh:arthroscopy
030229 sport sciences
Anatomy
musculoskeletal system
Popliteal artery
Surgery
lcsh:RD701-811
medicine.anatomical_structure
Orthopedic surgery
Original Article
mesh:Anterior cruciate ligament reconstruction
mesh:grafts
business
Cadaveric spasm
mesh:knee injuries
Zdroj: Indian Journal of Orthopaedics, Vol 50, Iss 6, Pp 677-685 (2016)
Indian Journal of Orthopaedics
ISSN: 1998-3727
0019-5413
Popis: Background: A common method for reconstruction of the anterior cruciate ligament (ACL) is it's replacement by a free avascular graft, using the gracilis and/or semitendinosus tendons. These grafts pass a vulnerable phase in the ligamentization-process during the 1 st year after reconstruction. The aims of this study were first to evaluate the vascularization of the pes anserinus superficialis (PAS) by the inferior medial genicular artery (IMGA) and second to develop a pedunculated surgical technique for ACL reconstruction, to preserve a maximal amount of natural vascularization of the tendons inserting at the PAS. Materials and Methods: First, the vascularization of the PAS was assessed in 12 fresh-frozen lower extremities. The IMGA was identified at its origin at the popliteal artery and perfused with a methylene blue solution. Second, a pedunculated ACL reconstruction was performed in 5 fresh-frozen lower extremities under maintenance of the distal tendon insertion at PAS. Results: The PAS is a highly vascularized structure. Vessels originate from the IMGA, running along the three tendons of the PAS in the paratendinous tissue. Histologically intratendinous vessels exist; however, perfusion of the inserting tendons through intratendinous vessels was not proven macroscopically. The pedunculated grafts could be positioned and fixed successfully into the bone tunnels in all knees. Conclusion: Although intratendinous vascularization of the tendons of the PAS via the IMGA was not proven, this study indicates a new possibility of ACL reconstruction. The described operation technique can be conducive to shorten the vulnerable phase of the graft-ligamentization after ACL reconstruction.
Databáze: OpenAIRE
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