The arterial anatomy of the medial femoral condyle and its clinical implications

Abstract

The success of vascularized bone grafts from the medial femoral condyle in various clinical applications has sparked renewed interest in the microvascular anatomy of this region. This study describes the arterial supply of the distal medial femoral condyle and its implications in harvesting vascularized bone grafts. The location, branching pattern, internal diameter, and distribution of perforators of the descending genicular artery and superior medial genicular artery in 19 fresh cadaveric lower limbs were recorded. The descending genicular artery was present in 89% and the superior medial genicular artery was present in 100% of specimens with average distances proximal to the articular surface of 13.7 cm and 5.2 cm, respectively. The average number of perforating vessels was greatest in the posterior distal quadrant of the condyle. The blood supply of the medial femoral condyle is plentiful and consistent making it a useful source for free vascularized bone grafts.

The demonstration of the number, course, and the location of nutrient artery canals of the femur by multidetector computed tomography

“…The localization of nutrient canal is important for bone graft selection. Yamamoto et al [19] stated that vascularized bone grafts have been used in reconstructive surgery for over a century in the treatment of nonunion fractures and avascular osteonecroses. In the transplant of the femoral diaphysis the deep femoral artery can be used; in the case of shorter grafts, it is necessary to consider the number and the locations of the nutrient foramina [6].…”

Cutaneous Angiosome Territory of the Medial Femoral Condyle Osteocutaneous Flap

“…32 The anatomy of the SAB, its origin, and its angiosome have been well described. [25][26][27][28] This vessel exists as a branch of the DGA in 79% of cases 27 and supplies a large angiosome extending from the medial knee to the medial aspect of the lower leg. 25 A well-performed cadaveric and clinical study originally describing a saphenous fasciocutaneous free flap noted that the perforators to the skin coming from the saphenous artery pass anterior to the sartorius muscle in 45% of cases.…”

Lateral Femoral Condyle Flap: An Alternative Source of Vascularized Bone From the Distal Femur

“…The MFC flap is typically harvested with the entire length of the descending geniculate artery (originating approximately 14 cm proximal to the joint line) with an effective pedicle length of 8 to 10 cm and an arterial lumen caliber up to 1.5 mm. 5,12 Although a long vascular pedicle is often useful in free flap reconstruction, it can be unwieldy in smaller dissection fields such as those used for carpal reconstruction. A volar approach to the scaphoid nonunion, for example, is quite amenable to microvascular reconstruction using a bone flap with large lumen caliber and shorter pedicle to anastomose to the nearby radial artery.…”