Background:The microvasculature of the human meniscus has been previously described by Arnoczky and Warren. However, to date, the qualitative and quantitative extra-articular vascular anatomy of the medial meniscus has not been characterized.Purposes:To perform a qualitative and quantitative anatomic study of the extra-articular medial meniscal vasculature and to introduce the novel “medial meniscal artery” (MMA), potentially providing future guidelines for the treatment of meniscal abnormalities.Study Design:Descriptive laboratory study.Methods:A total of 33 unpaired, frozen human cadaveric knees were dissected. The femoral artery was identified and cannulated using an angiocatheter. The arteries were perfused with a red acrylic paint solution, allowing for improved visualization. Artery dimensions and distances were measured using a digital caliper. Perfused specimens were imaged using computed tomography and segmented using 3D reconstruction software to identify vessels and repeat artery measurements digitally.Results:The MMA was consistently identified in all specimens. In 27 (82%) of 33 specimens, the MMA branched directly from the popliteal artery; in 5 (15%), the MMA shared a common trunk with the inferior medial genicular artery; and in 1 specimen (3%), the MMA shared a common branch with the inferior lateral genicular artery. The MMA was easily distinguishable from the superior, inferior, and middle genicular arteries, given its direct course to the medial joint line with terminal branches to the posterior horn of the medial meniscus and deep to the semimembranosus tendon. The MMA exhibited a consistently smaller vessel diameter relative to the genicular arteries.Conclusion:This is the first study to identify and quantitatively describe the MMA in the human knee. The MMA can be identified consistently on gross anatomic dissection in cadaveric donors of varying demographics. Further research is needed to identify and characterize the artery in vivo and to determine the MMA’s role in meniscus preservation surgery.Clinical Relevance:The findings of this study will provide future avenues of research toward understanding medial meniscus vascularization and the genesis of potential degenerative changes when vascularization is poor. This will help to further refine diagnostic and treatment options for meniscus revascularization and compartment preservation. Additionally, this study may help define safe zones in the knee during posterior approaches and expand the base of knowledge for emerging vascular procedures such as genicular artery embolization.

中文翻译：

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内侧半月板血管形成的新描述：一项介绍“内侧半月板动脉”的多中心研究


背景： 人类半月板的微血管系统先前已由 Arnoczky 和 Warren 描述。然而，迄今为止，内侧半月板的定性和定量关节外血管解剖结构尚未得到表征。目的： 对关节外内侧半月板脉管系统进行定性和定量解剖学研究，并引入新型“内侧半月板动脉”（MMA），可能为半月板异常的治疗提供未来指南。研究设计： 描述性实验室研究。方法： 解剖共 33 例未配对的冷冻人类尸体膝关节。使用血管导管识别股动脉并插管。动脉用红色丙烯酸涂料溶液灌注，以改善可视化。使用数字卡尺测量动脉尺寸和距离。使用计算机断层扫描对灌注标本进行成像，并使用 3D 重建软件进行分割，以识别血管并以数字方式重复动脉测量。结果： 在所有标本中一致鉴定 MMA。在 33 个标本中的 27 个 （82%） 中，MMA 直接从腘动脉分支;在 5 例 （15%） 中，MMA 与膝下内侧动脉共享一个共同的主干;在 1 个标本 （3%） 中，MMA 与膝下外侧动脉共享一个公共分支。MMA 很容易与膝上动脉、膝下动脉和膝中动脉区分开来，因为它直接走向内侧关节线，末端分支到内侧半月板的后角和半膜肌腱的深处。MMA 相对于膝动脉表现出始终较小的血管直径。结论： 这是第一项鉴定和定量描述人类膝关节 MMA 的研究。在不同人口统计学的尸体供体的大体解剖中可以一致地识别 MMA。需要进一步的研究来识别和表征体内动脉，并确定 MMA 在半月板保留手术中的作用。临床相关性： 本研究的结果将为理解内侧半月板血管形成和血管形成不良时潜在退行性变化的发生提供未来的研究途径。这将有助于进一步完善半月板血运重建和隔室保留的诊断和治疗方案。此外，这项研究可能有助于确定后路入路期间膝关节的安全区，并扩大新兴血管手术（如膝动脉栓塞术）的知识基础。