A method to quantify and visualize femoral head intraosseous arteries by micro‐CT

Qiu, Xing; Shi, Xianliang; Ouyang, Jun; Xu, Dan; Zhao, Dewei

doi:10.1111/joa.12475

Cited by 17 publications

(38 citation statements)

References 21 publications

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“…For this purpose, 5 specimens were dissected to expose the axillary artery, which were then cannulated with 5.0 mm plastic tubing. The specimens were then infused with 100 mL 10% barium sulfate solution containing a 3% gelatin mix 21 . The upper limb was then cooled in a refrigerator at 12°C for 20 minutes to allow the infusion to set.…”

Section: Methodsmentioning

confidence: 99%

An anatomical investigation into the blood supply of the proximal humerus: surgical considerations for rotator cuff repair

et al. 2019

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BackgroundThe purpose of this study was to investigate the blood supply of the humeral head (HH) originating from the anterior (ACHA) and posterior circumflex humeral arteries (PCHA).MethodsFormalin preserved specimens were used to measure ACHA length, ACHA length in the bicipital groove (BG), the length of the ascending branch of the ACHA, the penetration point of the ascending branch of the ACHA at the greater tuberosity (GT), and the penetration point of the ascending branch PCHA at the GT. Fresh specimens were used to identify the intraosseous vascular network by both the ACHA and PCHA by injecting a contrast medium using a high-resolution microfocus computed tomography. Specimens were then dissected to expose where the branches of the ACHA and PCHA penetrate the bone, and a small section of the medial head was removed to visualize dye penetration of the cancellous bone.ResultsSeven variations for the course of the ACHA were observed. In 36%, the ACHA runs posterior to the BG and posterior to the long head of biceps tendon, and splits into the anterolateral ascending and descending branch. The ascending branch enters the medial wall of the GT. Microfocus computed tomography demonstrated that the intraosseous branch of the ascending branch of the ACHA runs within the GT in a medial direction from its penetration point just along the lateral edge of the BG. Intraosseous accumulation of contrast within the GT supply occurs more toward the inferior aspect of the HH, and the anterior-superior and superior-medial aspect of the HH is not perfused. This region is a high-risk zone for avascular necrosis.ConclusionThe results of this study suggest that 7 variations for the course of the ACHA exist. These variations and the interruption of the intraosseous arterial network in the GT with surgery and suture anchor placement result in a high-risk zone in the superomedial aspect of the humeral head overlapping with the area where early aseptic necrosis is identified.

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Section: Methodsmentioning

confidence: 99%

An anatomical investigation into the blood supply of the proximal humerus: surgical considerations for rotator cuff repair

et al. 2019

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“…Published data for normal human femoral head intraosseous quantifying artery length densities, artery volume densities, and artery length/volume ratio were used for the normal control group. These femoral heads were free of any previous hip pathologies or surgeries and had no known history of previous traumatic injuries and no congenital abnormalities.…”

Section: Methodsmentioning

confidence: 99%

“…It is possible to study the structure of the microvasculature within the bone using ex vivo micro angiography, but it is significantly limited in that it usually must be observed by being sliced into pieces. Reportedly, a normal anatomic specimen can be reconstructed by vascular perfusion without destruction of the bone, which can be used to directly reconstruct the blood vessels in the bone, to display the intraosseous arterial structure and the fine vascular branch, and to quantify the bone structure simultaneously. However, most research has focused on the study of anatomical structures in normal cadavers through injections into the femoral artery (ϕ = 7 mm), and lower limb specimens of the skin and soft tissue structures must remain intact.…”

Section: Introductionmentioning

confidence: 99%

“…Reportedly, a normal anatomic specimen can be reconstructed by vascular perfusion without destruction of the bone, which can be used to directly reconstruct the blood vessels in the bone, to display the intraosseous arterial structure and the fine vascular branch, and to quantify the bone structure simultaneously. However, most research has focused on the study of anatomical structures in normal cadavers through injections into the femoral artery (ϕ = 7 mm), and lower limb specimens of the skin and soft tissue structures must remain intact. In the existing research method for femoral head samples, the intraosseous artery must first be decalcified.…”

Section: Introductionmentioning

confidence: 99%

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Micro Perfusion and Quantitative Analysis of the Femoral Head Intraosseous Artery

Qiu

Cheng

Wang

et al. 2018

Orthopaedic Surgery

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The present study investigates the feasibility of micro perfusion of femoral head specimens from femoral neck fracture patients by the inferior retinacular arteries and performing intraosseous artery quantitative analysis of the femoral head. Twelve femoral neck fracture patients who had undergone conventional hip replacement surgery were included in this study. Femoral head specimen arteries were first dissected and exposed and then perfused by the inferior retinacular arteries and all the femoral heads underwent micro-CT scanning. After micro-CT scanning, a digital 3-D model was reconstructed to quantify the femoral head intraosseous arteries for comparison with a normal femoral head. The artery length density, artery volume density, and artery length/volume ratio were calculated separately and compared with normal femoral head parameters. Micro-CT scanning displayed the epiphyseal arterial network structure and their fine vascular branches in all 12 femoral neck fractures. Blood was supplied from the inferior retinacular artery to the epiphyseal arterial network then to all the fine blood vessels within the femoral head. No statistical differences were observed in femoral heads' intraosseous artery length densities or volume densities between the normal and femoral neck fracture specimens, while the artery length/volume ratio showed a statistical difference, and the ratio increased from 19 to 46. Micro perfusion of the femoral head by the inferior retinacular arteries is possible and can present the epiphyseal network and their fine arterial branches in pathologic conditions to provide a morphological basis for the study of femoral head disease.

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“…The contrast agent preparation process was similar to a previous study [7]. Briefly, 30% barium sulfate and 5% gelatin suspension mixture was used as contrast agent.…”

Section: Methodsmentioning

confidence: 99%

A pilot study of blood supply of the coracoid process and the coracoid bone graft after Latarjet osteotomy

et al. 2019

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Latarjet osteotomy is still one of the most reliable and commonly used surgeries in treating recurrent anterior shoulder dislocation. The coracoid process (CP) is the main structure of this surgery. However, the blood supply of CP is not fully understood, and the extent of destruction of blood supply of coracoid bone graft after Latarjet osteotomy procedure is still controversial. Five embalmed cadaveric upper limbs specimens were employed for macro observation of the blood supply of CP. The conjoint tendon (CT) and CP interface were dissected for histology. Sixteen fresh frozen shoulder specimens were used for perfusion and micro CT scanning. Eight specimens were used to present the whole vessel structure of CP. The other eight underwent Latarjet osteotomy procedure. The coracoid bone grafts in both groups were scanned to clarify the remnant blood supply. It was found that the CP was nourished by supra-scapular artery (SSA), thoracic-acromial artery and branch from second portion of the axillary artery (AA). After Latarjet osteotomy procedure, no artery from CT was detected to penetrate the CP at its attachment. Only in one specimen the blood vessel that originated from the CT penetrated the bone graft at the inferior side. Therefore, most of the blood supply was destroyed although there is a subtle possibility that the vessels derived from the CT nourished the inferior side of the CP. In a nutshell, CP is a structure with rich blood supply. The traditional Latarjet osteotomy procedure would inevitably cut off the blood supply of the coracoid bone graft.

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A method to quantify and visualize femoral head intraosseous arteries by micro‐CT

Cited by 17 publications

References 21 publications

An anatomical investigation into the blood supply of the proximal humerus: surgical considerations for rotator cuff repair

An anatomical investigation into the blood supply of the proximal humerus: surgical considerations for rotator cuff repair

Micro Perfusion and Quantitative Analysis of the Femoral Head Intraosseous Artery

A pilot study of blood supply of the coracoid process and the coracoid bone graft after Latarjet osteotomy

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