de Carvalho Rogério Teixeira, Ramos Leonardo Addêo, Novaretti João Victor, Ribeiro Leandro Masini, Szeles Paulo Roberto de Queiroz, Ingham Sheila Jean McNeill, Abdalla Rene Jorge
Department of Orthopaedic Surgery, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Department of Orthopaedic Surgery, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.; Knee Institute of the Heart Hospital, São Paulo, Brazil.; AACD Rehabilitation Centre, São Paulo, Brazil.
Orthop J Sports Med. 2016 Dec 9;4(12):2325967116673579. doi: 10.1177/2325967116673579. eCollection 2016 Dec.
The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA.
To investigate the anatomy of the MGA and its relation to the posterior structures of the knees, mainly the posterior capsule and femoral condyles, and to establish safe parameters to avoid harming the MGA.
Descriptive laboratory study.
Dissection of the MGA was performed in 16 fresh, unpaired adult human cadaveric knees with no macroscopic degenerative or traumatic changes and no previous surgeries. The specimens were meticulously evaluated with emphasis on preservation of the MGA. The distances from the MGA to the medial and lateral femoral condyles were measured. The Mann-Whitney test was used for statistical analysis.
In all specimens, the MGA emerged from the anterior aspect of the popliteal artery, distal to the superior genicular arteries, and had a short distal trajectory toward the posterior capsule where it entered proximal to the oblique popliteal ligament. The artery lay in the midportion between the condyles. The distance between the posterior aspect of the tibia and the point of entry of the MGA into the posterior joint capsule was 23.8 ± 7.3 mm (range, 14.72-35.68 mm). There was no correlation between an individual's height and the distance of the entrance point of the MGA into the posterior joint capsule to the posterior superior corner of the tibia.
The middle genicular artery lies in the midportion between the medial and lateral femoral condyles.
This knowledge is important for the preservation of the blood supply during posterior knee surgical procedures and to settle a secure distance between the posterior aspect of the tibia and the MGA input. This could decrease and prevent iatrogenic vascular injury risk to the MGA.
膝中动脉（MGA）负责为交叉韧带和滑膜组织供血。外伤性运动损伤和外科手术（开放手术和关节镜手术）可导致血管损伤。对于确定MGA的安全参数，人们关注较少。
研究MGA的解剖结构及其与膝关节后部结构（主要是后关节囊和股骨髁）的关系，并确定避免损伤MGA的安全参数。
描述性实验室研究。
对16具无宏观退变或创伤性改变且未接受过先前手术的新鲜、不成对成年人体膝关节进行MGA解剖。对标本进行细致评估，重点是保留MGA。测量MGA到股骨内侧髁和外侧髁的距离。采用曼-惠特尼检验进行统计分析。
在所有标本中，MGA从腘动脉前侧发出，位于膝上动脉远端，向后方关节囊走行的远端较短，在腘斜韧带近端进入。该动脉位于两髁之间的中部。胫骨后侧与MGA进入后关节囊的点之间的距离为23.8±7.3mm（范围为14.72 - 35.68mm）。个体身高与MGA进入后关节囊的入口点到胫骨后上角的距离之间无相关性。
膝中动脉位于股骨内侧髁和外侧髁之间的中部。
这一知识对于在膝关节后部手术过程中保护血供以及确定胫骨后侧与MGA进入点之间的安全距离很重要。这可以降低并预防对MGA的医源性血管损伤风险。
