Anatomical variability of descending genicular artery

The main objective of this article was to provide a detailed description of the variability of the vascular anatomy of the medial femoral condyle corticoperiosteal flap.

The authors performed an anatomical dissection of the medial aspect of the genicular area of 20 lower limbs. The dissection isolated the different branches of the descending genicular artery (muscular, articular, and saphenous), after which the different branching patterns were recorded. Also the length, diameter, and distances of the main artery and its branches to the medial joint line of the knee were measured.

Three types of branching were identified, depending on whether all 3 branches shared a common origin (60%); only one of the branches had an isolated origin (30%); or all 3 branches had isolated origins (10%). The mean diameter of the descending genicular artery was 1.77 mm and arose from the femoral artery, 12.83 cm proximal to the medial joint line of the knee. The descending genicular artery was accompanied by 2 concomitant veins with a mean diameter of 1.98 mm. The articular branch reached the medial femoral condyle 6.2 cm proximal to the medial joint line of the knee. The average length of the articular branch from its origin was 5.3 cm.

Despite the relative anatomical variability, in 85% of cases, it is possible to elevate a corticoperiosteal graft using the descending genicular artery in association with other anatomical structures. The dissection of the corticoperiosteal medial condyle flap only becomes complicated with short vascular pedicles if the origin of the articular branch is isolated in the femoral artery.