膝关节动脉的血液供应

THE ARTERIAL SUPPLY OF THE HUMAN KNEE JOINT

本文通过动脉灌注,对120侧不同年龄(新生儿至87岁)尸体的膝关节骨性部和软组织的血液供应分别进行了研究。新生儿的膝动脉在软骨内分布呈节段性,软骨骨化后,骨骺和髌骨的动脉间建立广泛的吻合。骺软骨板分隔膝关节的骨骺与干骺端。随骺板的闭合,两者间有血管互相交通。骺板的血液供应来自骺动脉、干骺动脉和滋养动脉终末的毛细血管袢以及骨膜动脉网的小支。髌骨的动脉分3组,发自髌前丛和髌周动脉环。滑膜和髌下脂垫的血管分布丰富。肌睫和韧带在骨的附着处缺乏血管。成人半月板外1/5有血管分布,内4/5无血管。本文对膝关节血管分布的临床意义作了简要讨论。

The arterial supply of the human knee in 120 specimens,ranging in age from the newborn to 87 years,has been studied by the arterial perfusion method.The bony components as well as the soft tissues of the joint have been individually stu- died. At birth the genicular arteries have a segmental intraosseous distribution.With the completion of ossification free anastomoses are established inside both the epip- hyses and patella.The growth plate constitutes an absolute vascular barrier between the epiphysis and metaphysis of the knee.Vascular communications between the two territories appear at the closure of the epiphyseal plate. The epiphyseal plate is supplied by the terminal capillary loops of the epiphy- seal,metaphyseal and nutrient arteries and the fine branches of the periosteal arterial network. The patella is nourished by three systems of arteries arising from the prepatellar plexus and the peripatellar arterial circle. The rich vascularity of the synovial membrane and the infrapatellar fat pad is confirmed.The tendinous and ligamentous attachments to the bone are avascular. The peripheral one- fifth of the adult menisci is vascular and its inner four-fifths is avascular. The clinical significance of this study is briefly discussed.