VASCULAR ANATOMY OF THE HUMAN CRUCIATE LIGAMENTS AND SURROUNDING STRUCTURES

A detailed description of the arterial supply of the human cruciate li gaments and surrounding structures is reported as a result of autopsy dissection, contrast medium vascular injections (fine-grain x-rays, an d Spalteholz clearing of the specimens), and histologic studies in cad avers of various ages. It has been confirmed that the major supplying vessel is the middle genicular artery, which may show variations in it s origin and is frequently double. The fetal and neonatal connections between the branches of this artery and the vascular network of the in frapatellar fat pad, mainly nourished by the terminal branches of the inferior genicular arteries, are usually lost in the adult. A small am ount of blood comes to the lower portion of the anterior cruciate liga ment from the synovial network supplying the fat pad and the anterior horns of the menisci. Both the femoral and tibial attachments are depr ived of vascular penetration from the underlying bone. In spite of the relatively more abundant density of blood vessels around the posterio r cruciate ligament, no microangiographic and histological evidence sh ows that the amount of intrinsic vascularity differs in the two ligame nts. Finally, the clinical relevance of the gross and fine vascular an atomy of these articular structures in trauma surgery is considered. ( C) 1997 Wiley-Liss, Inc.