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Cellularity and Vascularity of the Developing Human Meniscus
Author(s):
Tompkins M. (United States of America)
Tompkins M. (United States of America)
Affiliations:
ESSKA Academy. Tompkins M. 05/09/18; 209763; P14-923 Topic: Anatomy
Assoc. Prof. Marc Tompkins
Assoc. Prof. Marc Tompkins
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Abstract
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Objectives: Vascularity and cellularity play a critical role in healing of meniscal tears. In skeletally immature patients, the degree of vascularity and cellularity may depend on age. Thus, understanding vascularity and cellularity by age yields an impact on the clinical management of meniscal tears. The aim of this study is to determine density of blood vessels and chondrocytes in cadaveric menisci from children. We hypothesized that the cellular and vascular density will increase from the central to peripheral menisci across all ages, and the cellular and vascular density will decrease with increasing age.

Methods: Twenty-eight medial menisci from cadavers of 23 children, ages 1month through 11 years, were studied. Menisci sections were routinely processed and stained with H&E to evaluate chondrocyte nuclei. A second set of sections was stained with Factor VIII-related antigen used to detect vascular endothelium. Images of the central, middle and peripheral thirds of each section were taken. The FIJI (TM) imaging program was used to measure the vessel area, number of chondrocytes, and total tissue area in each image. Vessel and cell density data was log-transformed and fit on a regression of density by age. For differences between regions, a repeated measures ANOVA was fit for density of each section by age on a log-transformed density. When bilateral specimens were available, the average of the two was used.

Results: Vessel density of the meniscus decreased significantly with age (p<0.001, R2=0.792). This was more variable in the younger samples than older. Vessel density by region was significantly different (repeated measures ANOVA; p=0.012). Significant pairwise differences in vessel density were observed between the posterior horn and posterior root(p=0.021) and the posterior horn and anterior root (p=0.022). The estimated mean vessel density increased in the following order: horns, body, roots. Age was not a significant predictor of regional differences (repeated measure ANOVA; p=0.80). Cellular density of the entire meniscus had similar trends to the total vessel density and decreased significantly with age (p<0.001, R2=0.794). Regional differences in cell density were significant (repeated measure ANOVA; p=0.0012). Pairwise differences were significant between the anterior root and body(p=0.0048), posterior root and the body (p=0.023) and the anterior root and posterior horn (p=0.023). The estimated mean cellular density increased in the order of body, horn, root (Figure 3). Age was not a significant predictor of regional differences (repeated measure ANOVA; p=0.88).

Conclusions: In conclusion, the vascular and cellular density of the entire meniscus decreased with increasing age and both were significantly different between regions. Vascular density was greatest in the roots, followed by the meniscal body, and least dense in the horns. Cell density was greatest in the roots, followed by the horns, and least dense in the body.

Keywords:
meniscus, tear, vascular density, cellular density
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