Park Jiwon, Lee Sang Soo, Kim Tae Woo
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, 200-704, South Korea.
Surg Radiol Anat. 2018 Jul;40(7):823-828. doi: 10.1007/s00276-018-2031-3. Epub 2018 Apr 24.
The inferior lateral genicular artery (ILGA) passes around the lateral knee joint, adjacent to the lateral meniscus (LM). ILGA injuries in total knee arthroplasty or arthroscopic surgery can result in recurrent hemarthrosis or painful pseudoaneurysms. Detailed information about the perimeniscal position of the ILGA relative to the LM is necessary to avoid these complications.
3-T MR images of 100 knees (mean age 36.3 ± 11.2 years) were retrospectively reviewed. The perimeniscal area was divided into four regions: the anterior, middle, popliteal hiatus, and posterior zones. In each zone, the ILGA diameter, superoinferior position (assessed as the height of the ILGA from the LM base), and distance between the meniscocapsular junction and the ILGA were measured.
The distance between the ILGA and meniscocapsular junction was significantly smaller in the middle zone than in the other three zones (anterior 5.3 ± 0.8 mm, middle 1.4 ± 0.4 mm, popliteal hiatus 6.1 ± 1.0 mm, and posterior 5.6 ± 1.5 mm, p < 0.05). In the superoinferior position, the height of the ILGA was 3.4 ± 0.9 mm in the anterior zone, 0.4 ± 1.3 mm in the middle zone, - 1.9 ± 1.8 mm in the popliteal hiatus zone, and - 1.3 ± 4.3 mm in the posterior zone. When the LM bottom is the base, the ILGA was located superiorly in the anterior zone, close to the base in the middle zone, and inferiorly in the popliteal hiatus zone.
To avoid ILGA injury, close attention is necessary during surgical procedures involving the meniscocapsular junction of the LM, especially at the meniscal base in the middle zone.
膝下外侧动脉(ILGA)绕过膝关节外侧,毗邻外侧半月板(LM)。全膝关节置换术或关节镜手术中ILGA损伤可导致反复关节积血或疼痛性假性动脉瘤。了解ILGA相对于LM的半月板周围位置的详细信息对于避免这些并发症至关重要。
回顾性分析100例膝关节(平均年龄36.3±11.2岁)的3-T磁共振成像。半月板周围区域分为四个区域:前区、中区、腘肌腱裂孔区和后区。在每个区域测量ILGA直径、上下位置(以ILGA距LM基底的高度评估)以及半月板-关节囊交界处与ILGA之间的距离。
中区ILGA与半月板-关节囊交界处的距离明显小于其他三个区域(前区5.3±0.8mm,中区1.4±0.4mm,腘肌腱裂孔区6.1±1.0mm,后区5.6±1.5mm,p<0.05)。在上下位置方面,前区ILGA高度为3.4±0.9mm,中区为0.4±1.3mm,腘肌腱裂孔区为-1.9±1.8mm,后区为-1.3±4.3mm。以LM底部为基准时,ILGA在前区位于上方,中区靠近基底,腘肌腱裂孔区位于下方。
为避免ILGA损伤,在涉及LM半月板-关节囊交界处的手术过程中,尤其是在中区半月板基底处,需要密切关注。