Main description:

Blood Supply of Bone: Scientific Aspects provides a comprehensive description of the development and physiology of blood supply to the skeleton. Investigative techniques for different types of bone in the body are discussed and the effects of disturbed circulation and the vascular control of osteogenesis is described. This highly illustrated and authoritative volume contains much revised material and many new illustrations reflecting 25 years of advances in this research field since the publication of its well-known precursor in 1971. The wealth of information will not only be invaluable to orthopaedic surgeons, rheumatologists, and radiologists but also pathologists, sports medicine specialists and bone metabolism research workers.

Contents:

1 Introduction.- Historical beginnings.- Modern vascular studies.- 2 Nutrient vessels in long bones.- Nutrient arteries.- Nutrient veins.- Arteries of the diaphysis.- Femoral diaphyseal nutrients.- Epiphyseo-metaphyseal arteries.- Diaphyseal nutrient ligation.- Blood supply of long bone epiphyses.- Blood supply of metaphyses.- 3 Modes of bone growth: disposition of the nutrient artery.- Inequality of longitudinal bone growth.- Differential growth at the epiphyses.- Fetal bone elongation.- Interstitial growth of the periosteum.- Muscle traction on the periosteum.- Bone remodelling.- Interstitial growth of systemic vessels.- Variant systemic arterial pattern.- Temporal variability of growth patterns.- Conclusion.- 4 Early development of nutrient vessels.- Diaphyseal vessels.- Epiphyseal vessels.- Formation of the metaphysis.- 5 Blood supply of irregular bones - 1: Vertebral column.- Vertebral development.- Vessels of the vertebral column and spinal cord.- Blood supply of the neural process.- Arteries of the vertebral body.- Intervertebral joints.- The vertebral column as a whole.- Blood vessels of the spinal cord.- Vertebral venous plexuses.- 6 Blood supply of irregular bones - 2: Carpal and tarsal bones.- Vessels of the carpus.- Vessels of individual carpal bones.- Hamate.- Capitate.- Pisiform.- Triquetrum.- Lunate.- Carpal scaphoid.- Radio-ulnar articular disc.- 7 Blood supply of flat bones.- Bones of the skull.- Membrane bones.- Meningeal arteries.- Flat bones developing in cartilage.- Pectoral girdle.- Vessels of the scapula.- Pelvic girdle.- Vessels of the hip bone.- Acetabulum.- Vessels of the ribs.- 8 Blood vessels in bone marrow.- Methods of investigation.- General features of the osseous circulation.- Vascular patterns.- Diaphysis.- Metaphysis.- Epiphysis.- Sinusoids in bone marrow.- Pulsation.- Lobulation and vascular shunts.- Open and closed circulation.- Phagocytosis.- Marrow endothelium.- Origin of angioblasts.- Regulators and mediators.- Conjunction of vascular territories in bone marrow.- 9 Cortex and periosteum.- Bone structure.- Blood vessels in the diaphysis.- Young cortex: medullary supply.- Centrifugal flow in young bone cortex.- Biomechanics of the osseous circulation.- Evidence for blood supply to young bone.- Concept of a dual blood supply.- Old cortex: medullary and periosteal supply.- Blood flow in old bone.- Clinical considerations.- Cortical vascular patterns.- Pattern determinants in bone cortex.- Vascular neogenesis.- Periosteum.- Bone cells and endothelial cells.- Syncytial character of osteocytes.- Origin of bone cells.- Factors acting on blood flow in cortex.- 10 Cartilage canals.- Mechanisms of cartilage growth.- Cartilage canal development.- Mechanisms of cartilage canal development.- Nutrient function.- Epiphyseal ossification.- 11 Growth cartilages.- Perichondral vessels.- Metaphyseal subchondral vessels.- Arterial supply.- The sinusoid network.- Isogenic columns or clumps.- Open or closed subchondral sinusoids.- Vascular endothelium and chondrolytic cells.- Vascular and trabecular pattern.- Mechanism of bone elongation.- Vessels crossing the cartilage.- Epiphyseal subchondral vessels.- Blood supply of growth cartilages.- 12 Synovial joints - 1.- Terms of reference.- Vascular anatomy.- Epiphyseal vessels.- Articular vessels.- Development of synovial joints.- 13 Synovial joints - 2.- Nutrition of articular cartilage.- Synovial nutrition of joint cartilage.- Synovial membrane.- Synovial vessels.- Turnover of synovial fluid.- Composition of synovial fluid.- Synovial cells and hyaluronate.- Synovial absorptive function.- Fluid production by capsular synovium.- Fluid production by transitional synovium.- 14 Synovial joints - 3.- Joint lubrication and cartilage nutrition.- Theories of lubrication.- Load and nutrition.- Articular nutrition of joint cartilage.- Permeability of articular bone plate.- Sulphate and oxygen diffusion.- Centrifugal diffusion from articular plexus.- Cartilage permeability, vascular contact and blood flow.- Changes in cartilage thickness.- Conclusions.- 15 Introduction to bone haemodynamics.- Low or high pressure system?.- Regulation of intravascular pressure.- Physical factors influencing flow rates.- Sinusoid dilatation and hyperaemia.- 16 Measurement of bone vascularity.- The volume of blood in bone.- Perfusion methods.- Red cell volume in bone.- Measurement of the vascular mesh.- 17 Bone blood flow measurement - 1: Indicator dilution.- Direct methods.- Venous effluent collection.- Venous plethysmography.- Red cell velocity.- Pressure, heat and electromagnetism.- Laser Doppler flowmetry.- Intravascular tracer dilution.- Iodoantipyrene washout.- Hydrogen washout.- Red cell dilution and follow-through curves.- Haematocrit and red cell velocity.- Flow rate and driving pressure.- Vascular stress in bone.- Flow rate and bone formation.- Plasma shift and synovial water.- 18 Bone blood flow measurement - 2: Clearance of bone seeking tracers.- Mathematical modelling.- Dynamic uptake.- 19 Bone blood flow measurement - 3: Arteriolar blockade.- Mixing of tracer particles.- Site of injection.- Size and density.- Arteriolar blockade: nature of particle tracer.- Resin particles versus microspheres: a practical digression.- 20 Disturbed osseous circulation - 1: Arterial ischaemia.- Fracture repair.- Arterial ischaemia.- The nutrient artery.- Metaphyseal arteries.- Epiphyseal arteries.- 21 Disturbed osseous circulation - 2: Effects of venous obstruction on bone.- Clinical experiences.- Effects of venous impediment on bone growth.- Effects of venous impediment on fracture repair.- Effects of venous impediment on knee joint morphology.- Venous impediment and clinical osteoarthrosis.- 22 Bone haemodynamics in venous impediment.- Mechanisms of action of venous ligation.- Haemodynamic changes.- Intravascular pressure.- Pressure transduction.- Stress-generated streaming potentials.- Hydrostatic pressure.- 23 Vascular control of osteogenesis.- Mechanical influences on bone formation.- Strain generated streaming potentials.- Pressure hypothesis.- Vascular control of osteogenesis.- Envoi.- Author Index.