Ahmed I M, Lagopoulos M, McConnell P, Soames R W, Sefton G K
Department of Human Biology, University of Leeds, England.
J Orthop Res. 1998 Sep;16(5):591-6. doi: 10.1002/jor.1100160511.
The Achilles tendon is one of the most common sites of injury and rupture as a result of overuse. Evidence suggests that the pathogenesis of rupture could involve the pattern of its blood supply. With use of angiographic and histological techniques, the blood supply of the Achilles tendon was investigated in 12 human cadaveric specimens. Angiography confirmed Mayer's 1916 finding that the blood supply to the tendon is from three areas: the musculotendinous and osseotendinous junctions and the paratenon, with the posterior tibial artery providing the major contribution. However, qualitative and quantitative histological analyses in this study showed that the Achilles tendon has a poor blood supply throughout its length, as determined by the small number of blood vessels per cross-sectional area, which do not in general vary significantly along its length. In light of these findings, it is suggested that poor vascularity may prevent adequate tissue repair following trauma, leading to further weakening of the tendon.
跟腱是因过度使用而导致损伤和断裂最常见的部位之一。有证据表明，断裂的发病机制可能涉及其血液供应模式。通过血管造影和组织学技术，对12具人类尸体标本的跟腱血液供应情况进行了研究。血管造影证实了迈尔在1916年的发现，即肌腱的血液供应来自三个区域：肌肉肌腱和骨肌腱结合处以及腱旁组织，胫后动脉起主要作用。然而，本研究中的定性和定量组织学分析表明，跟腱在其全长范围内血液供应较差，这是由每横截面积的血管数量较少决定的，而且这些血管数量一般沿其长度并无显著变化。鉴于这些发现，有人提出血管分布不佳可能会妨碍创伤后组织的充分修复，从而导致肌腱进一步弱化。
