Effects of Surgical Dissection on Blood Flow of Tibial Tubercle.

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Tibial tubercle transfer is often performed for patella maltracking. In this procedure, the periosteum of both sides of the tibia is stripped off along the tibial tubercle and then the bilateral cortices are transected. It is however likely to disturb blood supply to the tibial tubercle. We have, therefore, devised a new procedure in which the periosteum of the medial side of the proximal tibia is left intact when tibial tubercle transfer is performed. The purpose of this study is to investigate the blood supply to the tibial tubercle in an animal model using a hydrogen washout technique.10 mongrel dogs weighing 10.0 to 19.1kg were used. Blood flow was measured using a hydrogen washout technique.Before the surgical procedure, the control blood flow rate of the tibial tubercle averaged 19.2ml/minute per 100g of tissue. The blood flow rate did not significantly decrease after dissection of the periosteum on the lateral side of the tibia alone (p> 0.05). After the tibial tubercle osteotomy, the blood flow rate averaged 11.2ml/minute per 100g of tissue, which is a 26% decrease as compared with the value after dissection of the periosteum on the lateral side of the tibia alone (p<0.05). The blood flow rate significantly decreased to 3.4ml/minute per 100g of tissue after distal periosteal dissection (p<0.05). The addition of medial periosteal dissection caused a complete arrest of the blood flow in 11 out of 12 knees, which is a 99% decrease as compared with the value after distal periosteal dissection (p<0.05).

Effects of Surgical Dissection on Blood Flow of Tibial Tubercle.

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