2025 ISAKOS Biennial Congress Paper
Patient Specific Microvascularization of the Human Adult Meniscus: Is the Depth of Microvascular Penetration Correlated with Patient Characteristics?
Thies Johannes Nicolaas Van Der Lelij, MD NETHERLANDS
Peter Van Schie, MD, PhD, Zoetermeer, Zuid-Holland NETHERLANDS
Amber Weekhout, MD, Leiden, Zuid-Holland NETHERLANDS
Marta Fiocco, Prof., Leiden, Zuid-Holland NETHERLANDS
Roelina Munnik-Hagewoud, PhD, Zwolle, Overijssel NETHERLANDS
Stijn Keereweer, MD, PhD, Rotterdam, Zuid-Holland NETHERLANDS
Hans Marten Hazelbag, MD, PhD, Den Haag, Zuid-Holland NETHERLANDS
Ewoud R. Van Arkel, MD, PhD, Den Haag NETHERLANDS
Pieter Van Driel, MD, PhD, Zwolle, Overijssel NETHERLANDS
Haaglanden Medical Center, The Hague, South Holland, NETHERLANDS
FDA Status Not Applicable
Summary
This study found no significant correlation between patient characteristics (age, smoking, degree of osteoarthritis, and history of cardiovascular disease) and the extent of microvascularization in the menisci of adult patients, suggesting that these factors do not need to be considered when estimating the vascular status of a meniscal tear.
Abstract
Introduction
Current knowledge on the microvascular anatomy of adult human menisci is based on a few cadaveric studies. However, considerable interindividual variation in meniscal microvascularization has been reported in recent studies with small sample sizes. This study aimed to assess the correlation between patient characteristics and extent of microvascularization of the meniscus. Identifying such correlations may contribute to a more accurate and patient specific prediction of the vascular status of a meniscal tear and help to preoperatively estimate the chance of healing after repair.
Methods
Menisci from 174 patients who received total knee arthroplasty between March 2021 and December 2023 were collected. Three sections were made from each meniscus (anterior horn, midbody, and posterior horn) and immunohistochemical staining (CD-31) was used to visualize the microvasculature. The 4 primary outcome measures were the correlation between depth of microvascular penetration into the lateral meniscus (0-100%) and 1) age, 2) smoking, 3) degree of osteoarthritis, and 4) history of cardiovascular disease. To take the presence of repeated measurements for each patient into account, a linear mixed-effects model (LMM) was estimated to study the association between microvascularization and the patient characteristics previously introduced.
Results
The depth of vascular penetration into the lateral menisci ranged from 0%-78% and from 0%-67% in the medial menisci. There were no significant correlations between age, smoking, degree of osteoarthritis, or history of cardiovascular disease and degree of vascular penetration into the lateral meniscus. LMM analysis, adjusted for location within the meniscus and meniscal side (lateral or medial), showed no significant associations between patient characteristics and meniscal microvascularization.
Conclusion
There is a wide range in degree of microvascular penetration into the menisci among adults > 50 years. However, there is no correlation between the depth of microvascularization and either age, smoking, degree of osteoarthritis, or history of cardiovascular disease. This is the first study with adequate power to investigate the correlation between patient characteristics and degree of microvascularization of the adult human meniscus. Our findings suggest that patient characteristics do not need to be considered for the estimation of the vascular status of a meniscal tear and its subsequent chance of healing after repair.