髌韧带与膝交叉韧带的血供及其在交叉韧带损伤重建中的意义
Cruciate ligaments of knee and patellar tendon of blood supply and clinical significance in reconstruction of damaged cruciate ligaments
目的 探讨髌韧带和膝交叉韧带的血供特点,为临床韧带重建提供形态学依据。 方法 通过成人和胎儿股动脉红色乳胶灌注并解剖剥离、胎儿墨汁灌注组织透明和组织切片等方法，观察髌韧带和膝交叉韧带的动脉分布特点并测量胎儿韧带内微血管密度。 结果 髌韧带的动脉来自膝下外动脉、胫前返动脉、膝降动脉和膝下内动脉的分支；胎儿髌韧带不同区域微血管密度不同，且以韧带中心部为最低。前、后交叉韧带的动脉分别来源于膝中动脉、髌下脂肪垫以及膝下外动脉的分支。多数韧带内血管沿长轴走行，同时也有横向交通的小血管，血管网呈梯状或平行的丛状。近侧端和远侧端较密而中间部相对稀疏。 结论 ①髌韧带和膝交叉韧带均存在中心部乏血管区；②韧带两端血供最丰富，且近侧段好于远侧段；③髌韧带血供优于膝交叉韧带，髌韧带重建交叉韧带具有血供基础。
Objective To study the characteristics of the flow of blood in patellar tendon(PT) and cruciate ligament in order to provide the morphological basic data for ligament reconstruction in clinical medicine. Methods 42 cases of lower limb were selected, including 6 adults and 36 fetuses. The femoral artery of each limbs were first perfused with red latex and separated all the main blood vessels and other tissues (6 adults). Ink was injected into the arteries 30 fetuses, tissue sections were made and made transparent. The microvascular architecture of PT and cruciate ligament were observed and the blood capillary density of PT and cruciate ligament were measured under optical microscope. Ligaments of 6 fetal specimens were cut and made into HE sections, observed under optical microscope. Results The arteries of the PT comes from the branches of femoral artery; The microvascular density of foetal patella of different area varies. The distribution pattern of the arteries of the PT has the characteristic of low in intermediate while high on both sides. The artery of ACL and PCL is derived from the branch of the popliteal artery and patellar artery. Most of the blood vessels flow along the axis direction while some are crosswise, like a ladder and net-shaped at the same time. Conclusion ①Both of PT and cruciate ligament have a weak vascular area to the center; ②The most abundant blood supply are on the both ends of the ligament, and near side is better than distal one; ③The blood supply of the PT is better than cruciate ligament, PT has the better bloodsupply in cruciate ligament reconstruction
Patellar tendon / Cruciate ligaments of knee / Angioarchitecture / Reconstruction
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