Orellana Federica, Zaffagnini Stefano, Hlushchuk Ruslan, Khoma Oleksiy-Zakhar, Halm Sébastien, Parrilli Annapaola, Grassi Alberto
Empa-Swiss Federal Laboratories for Materials Science and Technology, Center for X-ray Analytics, Dübendorf, Switzerland.
IRCCS-Rizzoli Orthopaedic Institute, 2nd Orthopaedic and Traumatologic Clinic, Bologna, Italy.
Orthop J Sports Med. 2025 Jun 9;13(6):23259671251341472. doi: 10.1177/23259671251341472. eCollection 2025 Jun.
Degenerative meniscal lesions are often characterized by horizontal cleavage tears, and there is currently no established gold standard for treating these injuries. Understanding the vascularization and distribution of blood vessels along the meniscal layers could offer valuable insights into the management and healing of these tears.
Distinct vascularization patterns could be identified in different layers of the meniscus along the proximal-distal axis, providing new insights and potentially expanding or refining existing classification systems.
Descriptive laboratory study.
To visualize the meniscal microvasculature, human cadaveric legs were perfused with a polymer-based contrast agent, followed by micro-computed tomography imaging. The menisci were virtually divided into transverse (layers), radial (thirds), and circumferential zones to quantify the vascular contribution of each zone and to evaluate vascular parameters such as segment diameter, tortuosity, and the number of vessel segments.
In the medial meniscus, the inferior surface of the outermost zone and the intermediate layers of the peripheral zones showed a potential reduction in vessel percentage. In the lateral meniscus, a relatively higher percentage of vessels was observed from the superficial to the inferior layers of the posterior horn, extending into the inner zones. Additionally, the lateral meniscus exhibited a greater number of vessels with smaller diameters compared with the medial meniscus.
This micro-computed tomography approach for analyzing spatial vascular distribution offers a more comprehensive view of meniscal vasculature across multiple planes and regions.
This study may pave the way for new classifications that identify highly and poorly vascularized regions of the meniscus, potentially improving the effectiveness of treatments for meniscal injuries, ultimately reducing recovery time and improving long-term joint health for patients.
退行性半月板损伤通常以水平劈裂撕裂为特征，目前尚无治疗这些损伤的既定金标准。了解半月板各层的血管化情况以及血管分布，可为这些撕裂伤的处理和愈合提供有价值的见解。
沿半月板近远轴在不同层中可识别出不同的血管化模式，从而提供新的见解，并可能扩展或完善现有的分类系统。
描述性实验室研究。
为了可视化半月板微血管系统，向人类尸体下肢灌注基于聚合物的造影剂，随后进行微型计算机断层扫描成像。将半月板虚拟划分为横向（层）、径向（三分之一）和周向区域，以量化每个区域的血管贡献，并评估血管参数，如节段直径、迂曲度和血管节段数量。
在内侧半月板中，最外层区域的下表面和周边区域的中间层显示血管百分比可能降低。在外侧半月板中，从后角的浅层到下层观察到相对较高百分比的血管，延伸至内部区域。此外，与内侧半月板相比，外侧半月板的血管数量更多，直径更小。
这种用于分析空间血管分布的微型计算机断层扫描方法，能更全面地观察半月板在多个平面和区域的血管系统。
本研究可能为识别半月板血管丰富和血管较少区域的新分类方法铺平道路，有可能提高半月板损伤治疗的有效性，最终缩短患者的恢复时间并改善长期关节健康。
