Rectus femoris muscle grafts performed with and without vascular anastomosis: an experimental study in the rabbit

To study the effect of vascular repair on muscle transplants, rectus femoris muscles in rabbits were grafted orthotopically with and without microsurgical blood vessel repair. The function and structure of the grafts were evaluated 90 days after operation. Contractile properties were measured in vivo. Muscle biopsies were stained for nerve and motor end-plate regeneration. The twitch tension and maximal tetanic tension returned respectively to 32 +/- 6% and 32 +/- 7% of control values in the vascular transplants. In the avascular transplants twitch tension and maximal tetanic tension were respectively 6 +/- 1% and 8 +/- 1% of control values. Poor regeneration of muscle fibres, infection, fibrosis and immature reinnervation were the reasons for failure of avascular transplants. The avascular muscle grafts had insufficient contractile properties and were more static than dynamic. In conclusion, large avascular muscle grafts should be avoided because of the likelihood of poor revascularisation with extensive ischaemic necrosis, resulting in scar tissue.