Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Abstract

Introduction The descending genicular artery (DGA) has recently been mentioned as accompanying some nerves in the medial aspect of the knee joint. This could be clinically relevant as the arteries could serve as landmarks for accurate nerve capture during ultrasound‐guided nerve blockade or ablation. The aim of this cadaveric study was to investigate the anatomical distribution of the DGA, assess the nerves running alongside its branches, and discuss the implications for regional anesthesia and knee pain interventions. Methods We dissected the femoral artery (FA) all along its course to identify the origin of the DGA, from which we carefully dissected all branches, in 27 fresh‐frozen human specimens. Simultaneously, we systematically dissected the nerves supplying the medial aspect of the knee from proximally to distally and identified those running alongside the branches of the DGA. The surrounding anatomical landmarks were identified and measurements were recorded. Results The DGA was found in all specimens, arising from the FA 130.5 ± 17.5 mm (mean ± SD) proximally to the knee joint line. Seven distribution patterns of the DGA were observed. We found three consistent branches from the DGA running alongside their corresponding nerves at the level of the medial aspect of the knee: the artery of the superior‐medial genicular nerve, the artery of the infrapatellar branch of the saphenous nerve, and the saphenous branch of the DGA. Conclusion The consistent arteries and surrounding landmarks found in this study could help to improve the capture of the targeted nerves during ultrasound‐guided interventions.

Clinical applications and cadaveric study of the free descending genicular artery perforator flap without the saphenous vein

“…Except in the ankle, the SV is located on the surface of the deep fascia and is deeper than other superficial veins. Similar to deep veins, the surface of the SV has a dense envelope that separates it from other superficial veins [ 11 ]. Therefore, the superficial branch of the SV is often mistaken for its trunk on vascular ultrasound.…”