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患者特征与微血管向成人半月板渗透深度之间的关联

Association Between Patient Characteristics and the Depth of Microvascular Penetration Into the Adult Human Meniscus.

作者信息

van der Lelij Thies J N, van Schie Peter, Weekhout Amber, Fiocco Marta, Munnik-Hagewoud Roelina, Keereweer Stijn, Hazelbag Hans Marten, van Arkel Ewoud R A, van Driel Pieter B A A

机构信息

Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.

Mathematical Institute Leiden University, Leiden, The Netherlands.

出版信息

Am J Sports Med. 2025 Mar;53(3):658-665. doi: 10.1177/03635465241307216. Epub 2025 Jan 27.

Abstract

BACKGROUND

Current knowledge on the microvascular anatomy of adult human menisci is based on cadaveric studies. However, considerable interindividual variation in meniscal microvascularization has been reported in recent studies with small sample sizes.

PURPOSE

To assess the association between patient characteristics and the depth of microvascularization of the meniscus.

STUDY DESIGN

Descriptive laboratory study.

METHODS

Menisci from 174 patients who received total knee replacement between March 2021 and December 2023 were collected. A total of 174 lateral and 102 medial menisci were included. Three sections were made from each meniscus: the anterior horn, midbody, and posterior horn. Immunohistochemical staining (CD-31) was used to visualize the microvasculature. The 4 primary outcome measures were the correlation between the depth of microvascular penetration into the lateral meniscus (0%-100%) and (1) age, (2) smoking, (3) degree of osteoarthritis, and (4) history of cardiovascular disease. To account for repeated measurements within each patient, a linear mixed-effects model was estimated to study the association between microvascularization and the patient's characteristics previously introduced.

RESULTS

The depth of vascular penetration ranged from 0% to 78% into the lateral menisci and from 0% to 67% into the medial menisci. No significant correlations were found between age, smoking, degree of osteoarthritis, or history of cardiovascular disease and the degree of vascular penetration into the lateral meniscus. The linear mixed-effects model analysis, adjusted for location within the meniscus (anterior horn, midbody, or posterior horn) and meniscal side (lateral or medial), showed no significant associations between the same patient characteristics and meniscal microvascularization.

CONCLUSION

The degree of microvascular penetration into the meniscus has a wide range among adults >50 years. However, the depth of microvascularization was not associated with age, smoking, degree of osteoarthritis, or history of cardiovascular disease.

CLINICAL RELEVANCE

Because no associations were found between depth of microvascular penetration into the meniscus and patient characteristics, the latter cannot be used to estimate the vascular status of a meniscal tear in clinical practice.

摘要

背景

目前关于成年人类半月板微血管解剖结构的知识基于尸体研究。然而,最近小样本量的研究报告称半月板微血管化存在相当大的个体差异。

目的

评估患者特征与半月板微血管化深度之间的关联。

研究设计

描述性实验室研究。

方法

收集了2021年3月至2023年12月期间接受全膝关节置换术的174例患者的半月板。共纳入174个外侧半月板和102个内侧半月板。每个半月板制作三个切片:前角、体部和后角。采用免疫组织化学染色(CD-31)观察微血管系统。4个主要观察指标为外侧半月板微血管渗透深度(0%-100%)与(1)年龄、(2)吸烟、(3)骨关节炎程度和(4)心血管疾病史之间的相关性。为了考虑每个患者内的重复测量,估计了线性混合效应模型以研究微血管化与先前引入的患者特征之间的关联。

结果

外侧半月板的血管渗透深度为0%至78%,内侧半月板为0%至67%。年龄、吸烟、骨关节炎程度或心血管疾病史与外侧半月板的血管渗透程度之间未发现显著相关性。经半月板内位置(前角、体部或后角)和半月板侧别(外侧或内侧)调整后的线性混合效应模型分析显示,相同的患者特征与半月板微血管化之间无显著关联。

结论

50岁以上成年人半月板微血管渗透程度范围广泛。然而,微血管化深度与年龄、吸烟、骨关节炎程度或心血管疾病史无关。

临床意义

由于未发现半月板微血管渗透深度与患者特征之间存在关联,因此在临床实践中,后者不能用于估计半月板撕裂的血管状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fe0/11874502/bc0e6edf9ce0/10.1177_03635465241307216-fig1.jpg

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