Paper 238: Modification of the Human Meniscus Vascular Supply During Foetal Development: About 16 Cases

Abstract

The description of the vascularisation of the menisci, with 3 zones as described by Arnoczky, allows a better understanding of the mechanisms for meniscus healing. It was performed on adult meniscus. The purpose of this anatomical study was to describe the gradual changes in the vascular supply of the menisci during foetal development We studied 16 menisci (8 lateral menisci and 8 medial menisci) in 8 human fetus subjects, with ages ranging from 24 to 41 weeks of gestation. One case was used for the study of feasibility. The other 15 specimens were injected with India ink and dissected. They were then cleared using the Spalteholtz method, and then embedded in paraffin. Sections were cut and specific endothelial immunologic markers (CD 31, CD34, Factor VIII) were searched. We then studied the arterial part of the perimeniscal capillary plexus. The blood supply to the menisci comes from the superior and inferior branches of the medial and lateral geniculate arteries. These vessels were disposed predominantly in a circumferential pattern, with radial branches directed toward the central portion of the menisci. In the 24 weeks of gestation old fetus, in most cases, these vessels stop at the third external part of the meniscus. After 41 weeks of gestation, the vascular supply reaches the inner part of the meniscus. The vascular supply distribution and modification was the same in every menisci studied. Contrary to other publication, this study describes the vascular supply of the human meniscus only during foetal development. The vascularisation of the meniscus changes during the foetal development. Only localized in the lateral third during the foetal period, vascular supply reaches the inner part of the meniscus at the time of the birth. This may be clinically important for the comprehension of the development of degenerative changes and for the healing of meniscal lesion.