Descriptions of vessel angiosomes or perforasomes throughout the human body are quite frequent, and led to the development of flaps nowadays commonly used to surgically cover skin and soft tissue defects. In these procedures, the surgeon requires a profound anatomical knowledge of the respective blood vessels and the extent of the perfused area to define the size of the graft. In the region of the knee joint, descriptions of flaps based on the superior lateral genicular artery and descending genicular artery are quite frequent. In contrast, information regarding other popliteal branches is scarce or non‐existent. The aim of this study was to provide a concise and complete overview on the extent and variability of the perforator angiosomes of the femoral and popliteal arteries in the anterior knee region. Twenty lower extremities were dissected, the respective perforators identified and perfused with dye. All resulting angiosomes were marked and documented. A total of 84 angiosomes were identified in all specimens, with an average of 4.2 (3–6) angiosomes per specimen. The average size of the angiosomes was 97.04 ± 72.30 cm 2 (8.61–360.41 cm 2 ), their source vessels had an average diameter of 1.42 ± 0.54 mm (0.60–3.25 mm). The complex and highly variable distribution of perforator angiosomes of the anterior knee region and especially of its less frequently investigated distal part was demonstrated. Based on these results, the planning of existing perforator flaps in this region and the development of flaps including the inferior medial or inferior lateral genicular arteries may be facilitated.
BACKGROUND: During knee joint arthroscopy an easy orientation is important to achieve an anatomical correct reconstruction. The lateral intercondylar ridge (LIR) as well as the lateral bifurcate ridge (LBR) were described in literature as possible landmarks to find the location for the femoral tunnel placement. The objective of this trial was, to show the feasibility of the LIR and the LBR as landmarks of the femoral attachment of the ACL in all levels of specialization. METHODS: 36 formalin‐phenol‐fixed lower extremities from donations to the anatomical institute were required for this study. All soft tissue, apart from the knee ligament, was removed. The two bundles of the ACL were identified and marked. Afterwards, also the ACL was removed and the origin of the two bundles was marked and photographed. The bone of the intercondylar fossa was exposed and again photographs were taken. All photographs were made in a standardized setting. Using these photographs a trauma surgeon, an anatomist and a medical student had to identify and mark the ridges if discernible. RESULTS: There was a significant difference between the markings of the medical student on the one side and the trauma surgeon resp. the anatomist on the other side. CONCLUSIONS: This trial shows the feasibility of the LBR and LIR as osseous landmarks during arthroscopic surgery of the knee. As these ridges are not easily discernible, the surgeon has to know the anatomy of the intercondylar notch perfectly to stand even a small chance in correctly placing the drill hole in ACL reconstruction. For beginners in arthroscopic surgery, easier identifiably landmarks have to be introduced.
Introduction: The descending genicular vessels are widely used for free vascularized corticoperiosteal flaps of the medial condyle in cases with scaphoid nonunions. Due to the small diameter of the artery and the therefor demanding surgical procedure, this study aimed at the possibility of retrograde perfusion of the graft. Material and Methods: The descending genicular vessels (artery and veins) were extracted from 18 formalin‐fixed specimen of the anatomic institute. The samples were severed proximal at the level of the intermuscular septum and traced as far as possible towards the periosteum of the medial condyle of the femur. The veins were inspected macroscopically with help of a surgical microscope. Occurrence, distance and number of venous valves were documented. Results: The samples measured 5,1 ± 18 cm, each artery was accompanied by two veins in most cases (one vein in six specimen, three veins in one specimen, 32 veins in total). These veins had several intervenous connections. Of the 32 veins, 13 veins showed a venous valve, situated 1,6 ± 1,4 cm from the proximal end of the specimen. Of the 18 descending genicular vessels, there existed at least on vein in 14 samples without any venous valve. Conclusion: Provided previous intraoperative examination of the veins, retrograde perfusion of the free vascularized corticoperiosteal flap of the medial condyle and therefor arteriovenous anastomosis seems possible.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.