Discovery of Lijianmin-Chengkun Complexes and Their Oncological Application in Osseous and Intraarticular Lesions Around the Knee.

Xianhao Shao,Tao Liu,Yuchun Li,Ka Li,Zhenzhong Li,Yuan Yao,Jianmin Li,Ailin Zhang,Kun Cheng,Zhenfeng Li,Feifei Sun,Haiqing Hou,Qiang Yang,Qiuyao Li,Xiaofei Gao

doi:10.3389/fsurg.2021.691362

Abstract

Objective: This research aims to refresh the limited understanding about the canal and vascular structures within the epiphysis and metaphysis of the tibia and femur and their oncological significance.Methods: This study was started with characterization of a novel structure using radiographs and anatomic dissections, followed by a descriptive clinical study with 55 participants to investigate the effects of tumors on this novel discovery and a retrospective cohort study with 82 participants to investigate whether the structure would be a risk factor for tumor recurrence after the curettage of giant cell tumor of bone.Results: A new anatomical knee structure, the Lijianmin-Chengkun (LC) complex, was discovered in healthy adults, and its clinical implications were examined in this study. This new-found anatomical structure is composed of an epiphyseal and metaphyseal canal which surrounds a blood vessel, foramen, and foramen-covered synovium. All LC complexes showed similar radiographical, anatomical, and histological characteristics and were located within specific tibial and femoral intercondylar regions. These LC complexes seem to facilitate tumor residue and extension and may be a risk factor for tumor recurrence after curettage of femoral and tibial giant cell tumors (P = 0.031).Conclusion: The LC complexes are related to local tumor recurrence and bidirectional tumor dissemination between intraosseous and intraarticular regions. These findings have opened up a new perspective and may provide new targets for intervention in malignant and aggressive tumors around the knee joint.

Highlights

The knee joint has been subjected to extensive orthopedic research over the last century, mainly due to its complex anatomical structure and the fact that it is commonly affected in a variety of orthopedic diseases [1,2,3]
One foramen of the tibial intercondylar eminence (FTIE), which connects to a lowdensity canal extending to the tibial spongy bone, was found near the tibial intercondylar eminence (TIE)
In fifty 3D-computed tomography (CT) reconstructed images, 78.0% of FTIEs were located in Zone 5 or Zone 8, while 68.0% of intercondylar fossa foramen (IFF) were located in Zone 5 (Figures 2F,G)

Summary

Introduction

The knee joint has been subjected to extensive orthopedic research over the last century, mainly due to its complex anatomical structure and the fact that it is commonly affected in a variety of orthopedic diseases [1,2,3]. There is a lack of research and analysis concerning the terminal branches or tributaries of the genicular vessels, and no information has been provided about how these vessels penetrate bone through fixed foramina and canals. Compared to the nutrient foramen and canal in the diaphysis [11, 12], the vasculature-canal structures that traverse the subchondral bone and epiphysis to the metaphysis of femur and tibia have not been investigated. In 2019, the network of transcortical capillaries (TCVs) in the mouse and human tibia was discovered, which prompted the investigation of the circulatory and channel system in cortical bone [13], suggesting that the intraosseous vasculature and canal are worthy of further study

Methods

Results

Conclusion