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1.
Knee Surg Sports Traumatol Arthrosc ; 26(1): 146-151, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28624856

ABSTRACT

PURPOSE: A detailed structural anatomy of the posterosuperior shoulder capsule and "glenocapsular ligament" is still rather unknown. The purpose of this study was meticulously to investigate and describe the structure and blood supply of the glenocapsular ligament on the posterosuperior shoulder joint capsule. METHOD: Sixteen fixed and twelve fresh cadaveric shoulder specimens with a mean age of 73.4 (±6.4) years were analysed. Dissection without arterial injection was performed on the 16 fixed specimens-using an alcohol-formalin-glycerol solution. Before dissection, the 12 fresh specimens received of arterial injection a 10% aqueous dispersion of latex solution. After the injection, these shoulders were also fixed in an alcohol-formalin-glycerol solution. RESULTS: The glenocapsular ligament was found in all 28 specimens. Single or double parallel-running bundles of connective tissue fibres were found to form a capsular-ligamentous structure on the posterosuperior part of the joint capsule. One part of the ligament was mediosuperior, another posterosuperior. The mediosuperior part varied in shape, and in 12 of 28 cases, it was absent. The glenocapsular ligament arose from the supraglenoid tubercle and posterior part of the collum scapulae and inserted into the semicircular humeral ligament. The posterior ascending branch of the circumflex scapular artery directly fed small branches laterally and medially to the joint capsule, supplying the glenocapsular ligament and the deep layer of the joint capsule. CONCLUSION: The glenocapsular ligament is a constant anatomical structure that consists of one or two different parts. The glenocapsular ligament and the posterosuperior part of the joint capsule appear well vascularized via the posterior ascending branch of the circumflex scapular artery. CLINICAL RELEVANCE: It is the hope of the authors that this anatomical study can help surgeons who perform open or arthroscopic surgery to the posterior part of the shoulder. Knowledge of the vascular anatomy presented in this study may be especially important when incisions are made to the posterior part of the shoulder, and should minimize the risk of complications.


Subject(s)
Joint Capsule/blood supply , Ligaments, Articular/blood supply , Scapula/blood supply , Shoulder Joint/blood supply , Aged , Cadaver , Female , Humans , Joint Capsule/anatomy & histology , Ligaments, Articular/anatomy & histology , Male , Scapula/anatomy & histology , Shoulder Joint/anatomy & histology
2.
Surg Radiol Anat ; 39(9): 953-959, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28271273

ABSTRACT

Knowledge of the vascular supply associated with the sacrotuberous ligament is incomplete, and at most attributed to a single coccygeal branch. Our aim was to investigate the sacrotuberous ligament vasculature with a focus on its origin and distribution. We dissected 21 hemipelvises (10 male and 11 female). The gluteus maximus was reflected medially, and a special emphasis was placed on the dissection of the vascular and neuronal structures. All specimens exhibited several (1-4) coccygeal arteries branching from the inferior gluteal artery penetrating the sacrotuberous ligament along its length. Seven specimens demonstrated the superior gluteal artery supplying sacral branches to the proximal superior border of the sacrotuberous ligament. Our study highlights several branches from a variety of origins as the supply to sacrotuberous ligament unlike previous reports stating only one vessel. Our results implicate surgical procedures in and around the area of the gluteal region such as decompressive procedures of the pudendal nerve, as it travels between the sacrotuberous and sacrospinous ligaments.


Subject(s)
Anatomic Landmarks , Buttocks/blood supply , Ligaments, Articular/blood supply , Sacrum/blood supply , Adult , Cadaver , Dissection , Female , Humans , Male
3.
Anat Sci Int ; 92(1): 91-97, 2017 Jan.
Article in English | MEDLINE | ID: mdl-26690362

ABSTRACT

Precise knowledge of the vascular supply of the femoral head is critical when contemplating surgery around the femoral head and neck junction. To determine the blood supply to the femoral neck, 2417 nutrient foramina from 76 cadaveric specimens were analyzed based on size, number, and distribution. Within the subcapital, transcervical, and basicervical regions of the femoral neck, the largest numbers of nutrient foramina were found on the superior (lateral) surface, followed by the anterior and posterior surfaces, and then the inferior (medial) surface (all p < 0.001). The diameters of most of the nutrient foramina were less than 1 mm. For the posterior and superior surfaces, the nutrient foramina in the basicervical region were significantly larger than those within the transcervical or subcapital regions (nutrient foramina >2 mm posteriorly: 23.6, 12.7, and 9.0 % in the basicervical, transcervical, and subcapital regions, respectively; superiorly: 23.7 vs. 15.4 vs. 16.8 %, respectively). In conclusion, neither the anterior nor the inferior surfaces in the basicervical, transcervical, and subcapital regions showed any significant differences in nutrient foraminal size. The areas containing densely distributed nutrient foramina were consistent with the regions covered by the retinacula of Weitbrecht.


Subject(s)
Femur Neck/anatomy & histology , Femur Neck/blood supply , Ligaments, Articular/anatomy & histology , Ligaments, Articular/blood supply , Adult , Cadaver , Femur Neck/diagnostic imaging , Humans , Ligaments, Articular/diagnostic imaging , Synovial Membrane/anatomy & histology , Synovial Membrane/blood supply , Synovial Membrane/diagnostic imaging , Tomography, X-Ray Computed
4.
Vet Comp Orthop Traumatol ; 29(5): 361-8, 2016 Sep 20.
Article in English | MEDLINE | ID: mdl-27439659

ABSTRACT

OBJECTIVE: To evaluate the usefulness of laser Doppler flowmetry (LDF) to measure surface blood flow in canine cruciate ligaments, compare measurements in different sites of intact and partially ruptured canine cranial cruciate ligaments (CrCL) and intact caudal cruciate ligaments (CaCL), and investigate any association between surface blood flow in partially ruptured CrCL and synovitis or duration of clinical signs. STUDY DESIGN: Case-controlled clinical study. ANIMALS: Sixteen dogs with partially ruptured CrCL and five dogs with intact CrCL. METHODS: Blood cell flux (BCF) readings during three measurement cycles using LDF at two sites in each ligament (mid-substance and the distal portion of the CrCL, and mid-substance and the proximal portion of the CaCL) were recorded. Synovial changes were graded grossly and histologically using the Osteoarthritis Research Society International histopathology scoring system. RESULTS: The within-run coefficients of variation (CV) for a single BCF measurement cycle were 12.2% and 12.7% in the ruptured and intact CrCL groups, respectively. The between-run CV for three measurement cycles was 20.8% and 14.8%, respectively. The intraclass correlation coefficient (ICC, absolute agreement) was 0.66 for a single measurement cycle and 0.86 for the average of three cycles. No difference in average BCF readings was found between any two sites in either group, but BCF readings in both CrCL sites were significantly higher in the ruptured CrCL group than the intact CrCL group. No associations between BCF and synovial grades or duration of lameness were identified. CONCLUSIONS: Laser Doppler flowmetry can be used to assess surface blood flow in intact and partially ruptured canine cruciate ligaments with acceptable precision. Using this method, surface blood flow appears greater in partially ruptured canine CrCL than intact CrCL. Further studies are required to determine if this is a sequela of trauma or synovitis.


Subject(s)
Dogs/injuries , Laser-Doppler Flowmetry/veterinary , Ligaments, Articular/injuries , Rupture/veterinary , Animals , Arthroscopy/veterinary , Case-Control Studies , Dogs/surgery , Ligaments, Articular/blood supply , Ligaments, Articular/surgery
5.
Knee Surg Sports Traumatol Arthrosc ; 23(5): 1542-8, 2015 May.
Article in English | MEDLINE | ID: mdl-24633009

ABSTRACT

PURPOSE: The most common place for suprascapular nerve entrapment is the suprascapular notch. The aim of the study was to determine the morphological variation of the location of the suprascapular nerve, artery and vein, and measure the reduction in size of the suprascapular opening in each type of the passage. METHODS: A total of 106 human formalin-fixed cadaveric shoulders were included in the study. After dissection of the suprascapular region, the topography of the suprascapular nerve, artery and vein was evaluated. Additionally, the area of the suprascapular opening was measured using professional image analysis software. RESULTS: Four arrangements of the suprascapular vein, artery and nerve were distinguished with regard to the superior transverse scapular ligament: type I (61.3 %) (suprascapular artery was running above ligament, while suprascapular vein and nerve below it), type II (17 %) (both vessels pass above ligament, while nerve passes under it), type III (12.3 %) (suprascapular vessels and nerve lie under ligament) and type IV (9.4 %), which comprises the other variants of these structures. Statistically significant differences regarding the suprascapular opening were observed between the specimens with types II and III. Anterior coracoscapular ligaments were present in 55 from 106 shoulders. CONCLUSION: The morphological variations described in this study are necessary to better understand the possible anatomical conditions which may promote suprascapular nerve entrapment (especially type III). They may be useful during open and endoscopic procedures at the suprascapular notch to prevent such complications as unexpected bleeding.


Subject(s)
Arteries/anatomy & histology , Nerve Compression Syndromes/classification , Peripheral Nerves/anatomy & histology , Scapula/anatomy & histology , Cadaver , Humans , Ligaments, Articular/blood supply , Ligaments, Articular/innervation , Shoulder/blood supply , Shoulder/innervation
6.
J Bone Joint Surg Am ; 94(10): 931-8, 2012 May 16.
Article in English | MEDLINE | ID: mdl-22617922

ABSTRACT

BACKGROUND: Injuries to the tibiofibular syndesmosis commonly cause prolonged ankle pain and disability. Syndesmotic injuries are associated with slower healing rates compared with rates for other ankle ligament injuries and typically result in longer time away from sports. To our knowledge, the vascular supply to the syndesmosis and its clinical implication have not previously been studied. The purpose of this study was to describe the vascular supply to the tibiofibular syndesmosis with use of a method of chemical debridement of cadaveric specimens. METHODS: Twenty-five matched pairs of adult cadaver legs, fifty legs total, were amputated below the knee. India ink, followed by Ward Blue Latex, was injected into the anterior tibial, peroneal, and posterior tibial arteries under constant manual pressure to elucidate the vascular supply of the ankle syndesmotic ligaments. Chemical debridement was performed with 6.0% sodium hypochlorite to remove soft tissue, leaving bones, ligaments, and casts of the vascular anatomy intact. The vascular supply to the syndesmosis was evaluated and recorded. RESULTS: The anterior vascularity of the syndesmosis was clearly visualized in forty-three of fifty specimens. The peroneal artery supplied an anterior branch (the perforating branch) that perforated the interosseous membrane, an average of 3 cm proximal to the ankle joint. This branch provided the primary vascular supply to the anterior ligaments in twenty-seven specimens (63%). The anterior tibial artery provided additional contribution to the anterior ligaments in the remaining sixteen specimens (37%). CONCLUSIONS: The location of the perforating branch of the peroneal artery places it at risk when injury to the syndesmosis extends to the interosseous membrane 3 cm proximal to the ankle joint. In the majority of specimens, injury to this vessel would result in loss of the primary blood supply to the anterior ligaments.


Subject(s)
Ankle Joint/blood supply , Fibula/blood supply , Ligaments, Articular/blood supply , Tibia/blood supply , Adult , Cadaver , Humans
7.
AJR Am J Roentgenol ; 185(6): 1449-52, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16303996

ABSTRACT

OBJECTIVE: Our objective was to prove through cadaveric correlation that a frequently seen focus of MRI signal in the calcaneus is benign. CONCLUSION: A characteristic focus of signal (increased T2, decreased T1) in the calcaneus near the attachment of the cervical and interosseous ligaments is a common, benign finding frequently seen on MRI of the foot and ankle.


Subject(s)
Calcaneus/blood supply , Ligaments, Articular/blood supply , Magnetic Resonance Imaging/methods , Adolescent , Adult , Aged , Ankle Injuries/pathology , Athletic Injuries/pathology , Cadaver , Calcaneus/pathology , Child , Female , Humans , Male , Middle Aged , Retrospective Studies
8.
J Orthop Res ; 21(5): 787-91, 2003 Sep.
Article in English | MEDLINE | ID: mdl-12919864

ABSTRACT

Loss of the posterior cruciate ligament (PCL) of the knee has a significant impact on joint stability and biomechanical function. Changes in joint biomechanics may result in mal-adaptive tissue degeneration and functional alteration of supporting ligaments. This study examines the effects of joint laxity on the vascular physiology of the intact anterior cruciate (ACL) and medial collateral (MCL) ligaments after PCL transection in rabbits.One-year-old female New Zealand white rabbits were assigned to control (n=12), sham-operated (n=12) or PCL transected (2, 6 or 16 weeks, n=12 per time point) groups. Half of the animals (n=6 per group) were used for ACL and MCL blood flow determination using coloured microsphere infusion (ml/min/100 g), and half were used for vascular volume determination (given as vascular index, micro l/g). In the MCL, PCL transection induced large, significant (4-5-fold) increases in blood flow (peak at 2 weeks) and vascular index (peak at 6 weeks) compared to sham-operated animals that returned towards control values by 16 weeks. In contrast, the ACL showed no increase in blood flow in lax joints, and a relatively small (2-fold) increase in vascular index at 6 weeks only. The wet weight and water content of both the MCL and ACL were significantly increased in PCL-deficient joints. We conclude that joint laxity (instability) subsequent to loss of the PCL in rabbits impacts the vascular physiology of intact supporting ligaments, inducing both vasomotor and angiogenic responses in the MCL. Changes in wet weight and water content of both the MCL and ACL demonstrate prolonged physiological adaptation of intact structures in lax joints.


Subject(s)
Adaptation, Physiological , Joint Instability/etiology , Joint Instability/physiopathology , Ligaments, Articular/blood supply , Posterior Cruciate Ligament/injuries , Wounds, Penetrating/complications , Animals , Anterior Cruciate Ligament/blood supply , Biomechanical Phenomena , Blood Vessels/physiopathology , Female , Medial Collateral Ligament, Knee/blood supply , Rabbits , Regional Blood Flow
9.
Clin Orthop Relat Res ; (386): 210-7, 2001 May.
Article in English | MEDLINE | ID: mdl-11347838

ABSTRACT

To study revascularization of the artery of the ligamentum teres in Perthes disease, superselective angiography was done in 22 hips. Normal appearance of the artery of the ligamentum teres was observed in two hips, both of which were of Catterall Group II in the healing stage. Thirteen hips of Catterall Group III or IV with collapse (initial stage in nine hips, fragmentation in two hips, healing in two hips) were free from apparent subluxation; however, their epiphyses were not vascularized to the medial margin. Seven hips with apparent subluxation of Catterall Group III or IV (fragmentation stage in three hips, healing in four hips) had extensive vascularized medial viable segments consisting of newly formed small arteries. Penetration of revascularization from the artery of the ligamentum teres was inhibited by collapse initially at the medial margin of the epiphysis. Revascularization consisted of newly formed small arteries that penetrated the medial area of the epiphysis after subluxation. After completion of healing, blood supply from the artery of the ligamentum teres was not important for nourishment of the capital femoral epiphysis. The authors conclude that normal vascular anatomy of the artery of the ligamentum teres is not related to the onset of Perthes disease.


Subject(s)
Femur Head/blood supply , Hip Joint , Legg-Calve-Perthes Disease/diagnostic imaging , Ligaments, Articular/blood supply , Neovascularization, Physiologic/physiology , Adolescent , Age Factors , Angiography/methods , Arteries/physiology , Child , Child, Preschool , Disease Progression , Female , Humans , Infant, Newborn , Legg-Calve-Perthes Disease/physiopathology , Ligaments, Articular/diagnostic imaging , Male , Reference Values , Risk Assessment , Sensitivity and Specificity , Severity of Illness Index
10.
Clin Orthop Relat Res ; (382): 232-40, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11153993

ABSTRACT

Acetabular labrum tears have been implicated as a cause of hip pain in adult patients. Few studies describe the anatomy, histologic features, and microvasculature of the acetabular labrum and labral tears. Fifty-five embalmed and 12 fresh-frozen adult hips with a mean age of 78 years (range, 61-98 years) were studied. Of these, 96 % (53 of 55) of the hips had labral tears, with 74% of the tears located in the anterosuperior quadrant. Histologically, the fibrocartilaginous labrum was contiguous with the acetabular articular cartilage through a 1- to 2-mm zone of transition. A consistent projection of bone extends from the bony acetabulum into the substance of the labrum that is attached via a zone of calcified cartilage with a well-defined tidemark. Two distinct types of tears of the labrum were identified histologically. The first consisted of a detachment of the fibrocartilaginous labrum from the articular hyaline cartilage at the transition zone. The second consisted of one or more cleavage planes of variable depth within the substance of the labrum. Both types of labral tears were associated with increased microvessel formation seen within the tear. The acetabular labrum tear appears to be an acquired condition that is highly prevalent in aging adult hips. Labral tears occur early in the arthritic process of the hip and may be one of the causes of degenerative hip disease.


Subject(s)
Acetabulum/anatomy & histology , Acetabulum/blood supply , Acetabulum/injuries , Acetabulum/pathology , Aged , Aged, 80 and over , Aging/pathology , Arthritis/pathology , Cadaver , Calcification, Physiologic , Cartilage/anatomy & histology , Cartilage/blood supply , Cartilage, Articular/anatomy & histology , Cartilage, Articular/blood supply , Chondrocytes/pathology , Femur Head/pathology , Humans , Hyalin , Ligaments, Articular/anatomy & histology , Ligaments, Articular/blood supply , Microcirculation/anatomy & histology , Middle Aged , Osteoarthritis, Hip/pathology
11.
Z Orthop Ihre Grenzgeb ; 138(2): 174-80, 2000.
Article in German | MEDLINE | ID: mdl-10820886

ABSTRACT

INTRODUCTION: The most frequent site for aseptic bone necrosis and osteochondrosis dissecans in the human knee joint is the medial femoral condyle. The aim of this study is to analyze the three-dimensional vascularization of the human knee joint and to find out if there are any differences in the blood supply of the medial and lateral femoral condyles which may explain the preponderance of aseptic bone necrosis in the medial side. MATERIAL AND METHODS: The femoral arteries of 14 unfixed lower extremities have been injected with epoxy resin. After documentation of the extraosseous course of the blood vessels the bone was macerated with 10% formic acid. The insertions of tendons and ligaments were investigated by light microscopy and immunohistochemistry. RESULTS: The arterial supply of the lateral femoral condyle originates from the upper lateral geniculate artery, the terminal ends of which penetrate the bone from lateral. Branches of the middle geniculate artery reach the bone from the medial wall of the intertubercular notch. The subchondral bone of the medial femoral condyle draws its blood supply mainly from the descending geniculate artery. Branches of the middle geniculate artery penetrate the medial femoral condyle only in the posterior part of the intercondylar fossa. These posterior vessels do not contribute to the supply of the subchondral bone. In the anterior part of the medial wall of the intercondylar fossa there is the wide femoral insertion of the posterior cruciate ligament. Injection techniques and immunohistochemical investigations show that the fibrocartilage of the chondral apophyseal insertion of the posterior cruciate ligament is avascular and acts as banier which impedes blood vessels to penetrate the bony surface in this region. The subchondral bone adjacent to the femoral insertion of the posterior cruciate ligament receives its blood supply from vessels that penetrate the bone at the medial wall of the medial femoral condyle. The blood vessels which supply the lateral parts of the medial condyle have the longest intraosseous course. The density of vessels within this region is largely reduced. CONCLUSIONS: The region adjacent to the femoral insertion of the posterior cruciate ligament is the most frequent site for osteochondrosis dissecans in the knee joint. Our results show that the arterial supply of the subchondral bone may be considered as a cofactor for the etiology of osteochondrosis dissecans.


Subject(s)
Femoral Artery/pathology , Femur/blood supply , Knee Joint/blood supply , Osteochondritis Dissecans/pathology , Osteonecrosis/pathology , Aged , Capillaries/pathology , Female , Humans , Ligaments, Articular/blood supply , Ligaments, Articular/pathology , Male , Middle Aged , Reference Values
13.
J Bone Joint Surg Br ; 81(6): 991-4, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10615972

ABSTRACT

Thirty cruciate ligaments were retrieved from either cadavers or limbs which had been amputated. Each specimen was sectioned and stained to demonstrate the presence of collagen, nerves and vessels. All 30 specimens contained an interconnecting band of collagen fibres between the anterior and posterior cruciate ligaments. Vascular structures were present in all specimens and nerve fibres were identified in 26 (86%). We have called this structure the 'intercruciate band'. The anterior and posterior cruciate ligaments should no longer be thought of in isolation, but together as a 'cruciate complex'.


Subject(s)
Knee Joint/anatomy & histology , Ligaments, Articular/anatomy & histology , Anterior Cruciate Ligament/anatomy & histology , Female , Humans , Ligaments, Articular/blood supply , Ligaments, Articular/innervation , Male , Posterior Cruciate Ligament/anatomy & histology
14.
Med Biol Eng Comput ; 35(6): 581-6, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9538532

ABSTRACT

At present, there are only two laser Doppler perfusion imaging systems (LDIs) manufactured for medical applications: a 'stepwise' and a 'continuous' scanning LDI. The stepwise scanning LDI has previously been investigated and compared with coloured microsphere determined standardised flow. The continuous scanning LDI is investigated and compared with the stepwise scanning LDI for its ability to measure in vivo, hypoaemic, ligament tissue blood flow changes. The continuous scanning system was supplied with two lasers, red and near infrared (NIR), allowing for additional assessment of the effect of wavelength on imaging ligament perfusion. Perfusion images were obtained from surgically exposed rabbit medial collateral ligaments (MCL). Continuous and stepwise LDI scans were compared using correlation and linear regression analysis of image. averages and standard deviations. Using the same method of analysis, LDI measurements using red and NIR lasers indicated a high degree of correlation, at least over the ranges of perfusion assessed, indicating that red and NIR lasers measure similar regions of flow in the rabbit MCL. These experiments confirm that both LDI techniques provide a valid in vivo measure of dynamic changes in connective tissue perfusion and could have significant impact on the understanding and treatment of joint injury and arthritis.


Subject(s)
Knee Joint/blood supply , Laser-Doppler Flowmetry/methods , Ligaments, Articular/blood supply , Animals , Rabbits , Regional Blood Flow
15.
Med Biol Eng Comput ; 34(3): 227-31, 1996 May.
Article in English | MEDLINE | ID: mdl-8762830

ABSTRACT

Laser Doppler imaging (LDI) is investigated as a novel method for in vivo ligament tissue blood flow determination. LDI output signal is obtained from surgically exposed rabbit medial collateral ligaments (MCL). The LDI signal is compared with simultaneously determined, coloured microsphere (CM)-derived standardised MCL blood flow. Correlation of LDI output with the CM flow data and a linear regression of 17 data points in nine rabbits (joint injured to provoke an acute vascular response in the tissues) indicate that LDI provides a reasonable estimate of MCL blood flow, at least over the ranges assessed. If properly calibrated, and given enough tissue-specific data points, LDI may have advantages over conventional, but more invasive, techniques. The potential clinical application of LDI technology to joint injury and arthritis research is discussed.


Subject(s)
Knee Injuries/physiopathology , Knee Joint/blood supply , Laser-Doppler Flowmetry/methods , Ligaments, Articular/blood supply , Animals , Female , Ligaments, Articular/injuries , Rabbits , Regional Blood Flow
16.
Foot Ankle Int ; 17(2): 95-102, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8919408

ABSTRACT

In recent years there has been an increased interest in the treatment of acquired pes planus. The breakdown of the medial longitudinal arch is most often seen at the talonaviculocalcaneal articulation. This suggests a relationship between the ligamentous complex at this articulation and acquired pes planus. This study was undertaken to gain a better understanding of the gross, histologic, and microvascular anatomy, as well as the biomechanics of the ligamentous structures surrounding the talonaviculocalcaneal articulation. Cadaver dissections of 38 fresh-frozen feet were performed. Detailed descriptions of the gross anatomy of the superomedial calcaneonavicular ligament, inferior calcaneonavicular ligament, and the superficial deltoid ligament were recorded. Their relationships to the posterior tibialis tendon and to the bones of the talonaviculocalcaneal articulation are described. The histology and microvascularity of these structures were also studied. Preliminary biomechanical testing was performed. It was found there are two definitive anatomic structures that are commonly called the spring ligament: the superomedial calcaneonavicular ligament (SMCN) and the inferior calcaneonavicular ligament (ICN). The SMCN ligament was found to have histologic properties that suggest significant load bearing. The histology of the ICN ligament suggests a pure tensile load function. The deltoid ligament and the posterior tibialis tendon had direct attachments to the SMCN ligament in all specimens. An articular facet composed of fibrocartilage was found in each SMCN ligament specimen. The microvascular structures showed an avascular articular facet present in the ligament. The biomechanical testing showed that the SMCN ligament and ICN ligament had strength similar to ankle ligaments. This study suggests this "spring ligament complex" has more of a "sling" function for the talar head. It is hoped that the better understanding of this region will add to our understanding of the etiology of pes planus and possible treatment alternatives.


Subject(s)
Ligaments, Articular/anatomy & histology , Subtalar Joint/anatomy & histology , Biomechanical Phenomena , Cartilage, Articular/anatomy & histology , Humans , Ligaments, Articular/blood supply , Ligaments, Articular/physiology , Microcirculation , Subtalar Joint/blood supply , Subtalar Joint/physiology , Tendons/anatomy & histology
17.
Nihon Seikeigeka Gakkai Zasshi ; 66(10): 1016-30, 1992 Oct.
Article in Japanese | MEDLINE | ID: mdl-1460373

ABSTRACT

The effect of experimental autogenous tissue implantation (infrapatellar fat pad, fascia lata) together with scaffold type artificial ligament (Leeds-Keio) in ACL reconstruction was studied in 56 mongrel adult dogs. Specimens were examined macroscopically, histologically and by means of microangiography. The results were compared with those in which the artificial ligament was used alone. When infrapatellar fat pad was transferred on artificial ligament, tissue induction was observed 2 weeks after reconstruction. When ACL was reconstructed using a combination of artificial ligament and a small piece of fascia lata, maturated dense collagen fibers were observed 24 weeks after reconstruction. These results indicated that quicker tissue induction could be obtained in ACL reconstruction using an artificial ligament together with a infrapatellar fat pad, and that collagen fiber maturation was accelerated when ACL was reconstructed using an artificial ligament together with a small piece of fascia lata.


Subject(s)
Knee Joint/surgery , Ligaments, Articular/surgery , Prostheses and Implants , Regeneration , Adipose Tissue , Animals , Collagen/metabolism , Dogs , Fascia Lata , Ligaments, Articular/blood supply , Ligaments, Articular/physiology , Patella , Polyesters
18.
IEEE Trans Biomed Eng ; 39(3): 296-306, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1555860

ABSTRACT

An image analysis technique has been developed to quantitatively describe the fine vascular patterns observed in ligament tissue. The longitudinal orientational distribution and total vessel volume of India-ink-perfused blood vessel segments in normal and healing ligaments were determined. The methods involved special vascular preparation of adult rabbit knee medial collateral ligaments (MCL) by India-ink perfusion. Black and white microscope images of ink-perfused tissue sections were subjected to a thresholding procedure to binarize digitized ligament images, which were then skeletonized and analyzed for directional distribution based on the least-squares technique. Analysis of medial collateral ligaments in New Zealand White rabbits using this method has shown that scarred tissue is more vascular and has a more chaotic angular distribution of blood-vessel segments than normal ligament tissue.


Subject(s)
Image Processing, Computer-Assisted/methods , Knee Joint , Ligaments, Articular/blood supply , Algorithms , Animals , Female , In Vitro Techniques , Least-Squares Analysis , Ligaments, Articular/injuries , Rabbits , Reference Values , Wound Healing/physiology
19.
Arch Orthop Trauma Surg ; 111(5): 273-9, 1992.
Article in English | MEDLINE | ID: mdl-1389780

ABSTRACT

A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to reproduce the fiber organization anatomy of attachment site, vascularity, or function of the ACL. Twenty-nine foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device (LAD). Biomechanical, microvascular, and histological changes were evaluated 3, 6, and 12 months following implantation. The maximum loads of the allograft/LADs were 34.3% (387.2 N) after 3 months, 49.3% (556.6 N) after 6 months, and 61.1% (698.8 N) after a year. The maximum load was 69.1% (780 N). In general, after 6 months the allografts showed normal collagen orientation. The allografts demonstrated no evidence of infection or immune reaction. No bone ingrowth into the LAD was observed. Polarized light microscopy and periodic acid-schiff staining showed that the new bone-ligament substance interface had intact fiber orientation at the area of the ligament insertion. Microvascular examination using the Spalteholtz technique revealed revascularization and the importance of an infrapatellar fat pad for the nourishment of ACL allografts.


Subject(s)
Anterior Cruciate Ligament/transplantation , Knee Joint/surgery , Ligaments, Articular/surgery , Angiography , Animals , Anterior Cruciate Ligament/blood supply , Anterior Cruciate Ligament/cytology , Dogs , Ligaments, Articular/blood supply , Ligaments, Articular/cytology , Microradiography , Tensile Strength
20.
Acta Anat (Basel) ; 145(4): 412-5, 1992.
Article in English | MEDLINE | ID: mdl-10457786

ABSTRACT

The blood supply of the shoulder muscles, ligaments and joint capsule was investigated by injection of silicone rubber into the arteria subclavia of postmortem cases. We show that the a. suprascapularis forms important anatomoses with other arteries in the region and is of greater importance for the blood supply of the rotator cuff as hitherto believed. We also describe the a. subcoracoidea as a so far unknown branch of the a. axillaris.


Subject(s)
Shoulder/blood supply , Axillary Artery/anatomy & histology , Female , Humans , Ligaments, Articular/blood supply , Male , Muscle, Skeletal/blood supply , Shoulder Joint/blood supply , Subclavian Artery/anatomy & histology
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