Vialle R, Tanguy J Y, Cronier P, Fournier H D, Papon X, Mercier P
Laboratoire d'Anatomie, Faculté de Médecine, Angers, France.
Surg Radiol Anat. 1999;21(1):49-53. doi: 10.1007/BF01635052.
Arthroscopic lateral retinacular release can be complicated by hemarthrosis in 10 to 18% of cases. The vascular structures involved are the lateral vascular pedicles of the knee. This study examines the topography of these pedicles. Anatomic and radioanatomic studies carried out in 50 specimens defined the route of the vascular pedicles at the lateral aspect of the knee. From the measurements carried out, we noted the relative homogeneity of the routes taken by the different proximo-lateral vascular pedicles, which are highly vulnerable, and the variability of the disto-lateral arterial routes. A tracing-paper study identified two distinct routes for the disto-lateral vascular pedicle and evaluated the risk of injury to it in surgical approaches to the lateral aspect of the knee. Finally, the topographic data of the study suggest the possibility of preventive hemostasis of the proximo-lateral pedicle via a minimal approach close to the patella. Furthermore, it seems possible to avoid cutting the disto-lateral pedicle if it is localised by cutaneous trans-illumination at the beginning of the operation.
关节镜下外侧支持带松解术在10%至18%的病例中可能并发关节积血。涉及的血管结构是膝关节的外侧血管蒂。本研究检查了这些血管蒂的局部解剖情况。对50个标本进行的解剖学和放射解剖学研究确定了膝关节外侧血管蒂的走行路径。通过测量，我们注意到不同近端外侧血管蒂所走路径相对均匀，这些血管蒂极易受损，而远端外侧动脉路径存在变异性。一项描图纸研究确定了远端外侧血管蒂的两条不同走行路径，并评估了在膝关节外侧手术入路中其受伤的风险。最后，该研究的局部解剖学数据表明，通过靠近髌骨的微创入路对近端外侧血管蒂进行预防性止血是可能的。此外，如果在手术开始时通过皮肤透照定位远端外侧血管蒂，似乎有可能避免切断它。
