Importance of Arterial Blood Supply to the Femur and Tibia for Transplantation of Vascularized Femoral Diaphyses and Knee Joints

The role of the periosteal and intraosseous blood supply to the femur and the proximal tibia was investigated to improve the operating technique for transplantation of allogenic vascularized femoral diaphyses and knee joints in humans. Altogether 48 limbs were injected with gelatin, red latex milk,...

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Bibliographic Details
Published in:	World journal of surgery Vol. 22; no. 8; pp. 845 - 852
Main Authors:	Kirschner, Martin H., Menck, Johannes, Hennerbichler, Alfred, Gaber, Othmar, Hofmann, Gunther O.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer‐Verlag 01-08-1998 Springer Nature B.V
Subjects:	Aged Aged, 80 and over Bone Transplantation Diaphyses - blood supply Diaphyses - transplantation Female Femoral Artery Femoral Artery - anatomy & histology Femoral Diaphysis Femur - blood supply Femur - transplantation Humans Knee Joint - blood supply Knee Joint - surgery Male Middle Aged Models, Anatomic Periosteum - blood supply Popliteal Artery Proximal Tibia Tibia - blood supply Tibia - transplantation Tibial Arteries - anatomy & histology Tibial Plateau
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Summary:	The role of the periosteal and intraosseous blood supply to the femur and the proximal tibia was investigated to improve the operating technique for transplantation of allogenic vascularized femoral diaphyses and knee joints in humans. Altogether 48 limbs were injected with gelatin, red latex milk, or Revertex and macroscopically prepared; 41 limbs were studied for the variation and division of the truncus profundo‐circumflexus. In 200 femurs and 200 tibias the location of the nutrient foramen was determined. The arteries supplying the periosteum of the distal femur and the proximal tibia have defined nutritive areas. The following technique should be followed: If the femoral artery alone is prepared as the vascular pedicle, the optimal section for resection of the femur in knee joint transplantations is 6 to 12 cm above the level of the femur condyles and 5 to 7 cm below the tibial plateau. For the transplantation of femoral diaphyses, the deep femoral artery can be used if the lateral femoral circumflex artery is protected. The proximal line of resection is defined between the greater and lesser trochanter. For shorter grafts one must consider the number and location of nutrient foramens. For longer grafts the distal branches of the femoral artery must be respected as the intraosseous blood supply reaches distally down to the level of about 8 cm above the femoral condyles. In all these operations the variation of the truncus profundo‐circumflexus and the trifurcation of the popliteal artery must be considered.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0364-2313 1432-2323
DOI:	10.1007/s002689900480