Abstract
Introduction
The superficial anterior vasculature of the knee is variably described; most of our information comes from anatomical literature. Descriptions commonly emphasise medial-dominant genicular branches of the popliteal artery. Quantifying the relative contribution of medial and lateral vessels to the anastomotic network of the anterior knee may help provide grounds for selecting one of a number of popular incisions for arthrotomy.
Aim
To describe the relative contribution of vessels to anastomoses supplying the anterior knee.
Method
Cadaveric knees (n = 16) were injected at the popliteal artery with a single colour of latex; then processed through a modified diaphanisation technique (chemical tissue clearance) before final dissection and analysis. The dominant sources were determined in each specimen. Specimens were reconstructed using 3D microscribe technology for further quantification.
Results
The majority of the specimens (n = 13/16; 81%) demonstrated that an intramuscular branch though the vastus medialis muscle was the dominant vessel, giving rise to 65% of all vessels seen on the medial side of specimens. Mean gauge of source vessel seen over the superior medial aspect of the knee (2.4mm) was greater than that of the lateral side (1.0mm; p< 0.05). Medial-medial anastomoses (n=13/16; 81%) were seen more frequently than lateral to lateral (n=4/16; 25%; p< 0.05).
Discussion
The results suggest that anterior vasculature of the knee is predominately medial in origin, but not from the genicular branches as previously described. The networks of vessels found in the anterior knee are thought to be the main supply to the patella, extensor apparatus, anterior joint capsule and skin.
Optimum placement of incision for arthrotomy is a subject of debate. Considering the main blood supply to the anterior knee may help in choosing a particular approach.
