Vascular anatomy of the lateral meniscus with special focus on the joint capsule
Yutaro Natsuyama1,2, Yuka Mitsuya3, Miyuki Kuramasu3
1Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Tokyo, Japan. natsuyama.yutaro.8b@tokyo-med.ac.jp.
Abstract:
Previous studies have reported that the lateral meniscus (LM) has two regions, the popliteal hiatus area (PH) with a scarce blood supply and the roots with an abundant one. However, the description of its vascular anatomy remains insufficient. We hypothesized that the difference in the width of the meniscus hilum (MH) affects the scarcity and abundance of blood supply to the LM. The MH is a concept proposed by us and is the only site of entrance or exit of blood vessels and nerves associated with the meniscus. The purpose of this study was to provide a structural explanation for the disparity of blood supply to the LM using the concept of MH. Sixteen knees were examined to investigate the blood supply to LM. In most areas, the femoral joint capsule (FJC) and tibial joint capsule (TJC) continued to the cranial and caudal edges of the LM, respectively. In the roots, the FJC and TJC covered the femoral and the outer-femoral surfaces. In contrast, the FJC in the PH did not attach to the cranial edge and only the TJC there did to the caudal edge of the LM. Histochemical examination showed that the blood vessels enter the LM via the MH. In the PH, the MH at the caudal edge was extremely narrow; and in the roots, the MH on the outer-femoral surfaces was wide. The results suggest that the difference in the width of the MH affected the scarcity and abundance of blood supply to the LM.
Insights
The meniscus hilum
Area of Science:
- Orthopedics
- Anatomy
- Vascular Biology
Background:
- The lateral meniscus (LM) exhibits differential vascularization, with scarce supply in the popliteal hiatus (PH) and abundant supply at the roots.
- Existing anatomical descriptions of LM vascularity are incomplete, necessitating further investigation.
Purpose of the Study:
- To elucidate the structural basis for the varying blood supply to the lateral meniscus.
- To investigate the role of the meniscus hilum (MH) in regulating vascular access to the LM.
Main Methods:
- Examination of 16 human knees to analyze the vascular anatomy of the lateral meniscus.
- Histochemical analysis to identify blood vessel entry points into the LM.
- Assessment of the meniscus hilum (MH) width in different regions of the LM.
Main Results:
- Blood vessels exclusively enter the lateral meniscus (LM) through the meniscus hilum (MH).
- The meniscus hilum (MH) is significantly narrower at the popliteal hiatus (PH) compared to the meniscus roots.
- Capsular attachments (femoral joint capsule and tibial joint capsule) vary between the PH and roots, influencing vascular access.
Conclusions:
- The width of the meniscus hilum (MH) is a critical determinant of blood supply distribution within the lateral meniscus (LM).
- Narrowing of the meniscus hilum (MH) at the popliteal hiatus (PH) explains its poor vascularity.
- Understanding the meniscus hilum's (MH) role is crucial for comprehending lateral meniscus (LM) vascular anatomy and healing potential.
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