Kirschner M H, Menck J, Hofmann G O
Department of Surgery, University of Munich, Klinikum Grosshadern, München, Germany.
Surg Radiol Anat. 1996;18(4):263-9. doi: 10.1007/BF01627603.
The vitality of a graft in a vascularized allogenic knee joint transplantation in humans will depend strongly on maintaining the arterial blood supply to the bone. As can be demonstrated in injected specimens on cadavers, only periostal aa. are important to ensure the blood supply of the human knee joint. The main arteries have defined nutritive areas. According to our results access to the vessels should most probably be conducted from the dorsal side of the knee. During the explantation the popliteal a. should be ligated proximally as high up as possible and distally just above its trifurcation. The articular branch of the descending genicular a. of both the donor and the recipient can be ligated because of a rich anastomotic network. The medial and lateral inferior genicular aa. of the donor should be ligated ventrally as far forward as possible. One should, above all, preserve the medial inferior genicular a. of the donor in order not to endanger the medial part of the distal segment of the graft. If an operation is to be performed according to the results of our anatomical studies, vascularized allogenic knee joint transplantations should be successful from an anatomical point of view.
在人体血管化同种异体膝关节移植中，移植物的活力将在很大程度上取决于维持对骨骼的动脉血液供应。正如在尸体注射标本中所显示的那样，只有骨膜动脉对于确保人体膝关节的血液供应至关重要。主要动脉具有明确的营养区域。根据我们的研究结果，进入血管最有可能应从膝关节的背侧进行。在切除过程中，腘动脉应在近端尽可能高位结扎，在远端恰好在其分叉上方结扎。由于丰富的吻合网络，供体和受体的膝降动脉的关节支均可结扎。供体的膝下内侧和外侧动脉应在腹侧尽可能向前结扎。最重要的是，应保留供体的膝下内侧动脉，以免危及移植物远端节段的内侧部分。如果根据我们的解剖学研究结果进行手术，从解剖学角度来看，血管化同种异体膝关节移植应该会成功。
