The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

Abstract

Background and Objectives. The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the literature. The aim of this study was to determine the true prevalence of these characteristics and to study their associated anatomical and clinical relevance.Methods. A search of the major electronic databases Pubmed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed to identify all articles reporting data on the origin of the MCFA, its branching patterns and its distance to the MIP. No data or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching and distance to MIP was extracted and pooled into a meta-analysis using MetaXL v2.0.Results. A total of 38 (36 cadaveric and 2 imaging) studies (n = 4,351 lower limbs) were included into the meta-analysis. The pooled prevalence of the MCFA originating from the DFA was 64.6% (95% CI [58.0–71.5]), while the pooled prevalence of the MCFA originating from the CFA was 32.2% (95% CI [25.9–39.1]). The CFA-derived MCFA was found to originate as a single branch in 81.1% (95% CI [70.1–91.7]) of cases with a mean pooled distance of 50.14 mm (95% CI [42.50–57.78]) from the MIP.Conclusion. The MCFA’s variability must be taken into account by surgeons, especially during orthopedic interventions in the region of the hip to prevent iatrogenic injury to the circulation of the femoral head. Based on our analysis, we present a new proposed classification system for origin of the MCFA.

A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification

“…The anatomical variations of the vessels of the lower limb have long received attention from various authors [3, 5-9, 12-14, 19-22]. Within the arterial network of the lower limb, a number of variations can be seen regarding the morphology of the femoral artery (FA) and its main branches, especially the medial femoral circumflex artery (MFCA) and lateral femoral circumflex artery (LFCA) [8,9,14,19,22,[24][25][26]. The FA is found below the inguinal ligament as a continuation of the external iliac artery, and serves as the main vessel carrying blood to the lower limb.…”

The variable origin of the lateral circumflex femoral artery: a meta-analysis and proposal for a new classification system

“…The lateral circumflex femoral artery (LCFA) is a laterally running branch of the deep femoral artery (DFA), or less frequently, the common femoral artery (CFA) [1,30,31]. It most often arises from the root of the DFA and passes between divisions of the femoral nerve, posteriorly to the sartorius and rectus femoris muscles.…”

Development of the Anatomical Quality Assessment (AQUA) Tool for the quality assessment of anatomical studies included in meta‐analyses and systematic reviews

“…Items for the AQUA Tool were generated on the basis of (1) the extensive background of the steering committee in conceiving and executing anatomical metaanalyses and systematic reviews, and (2) a review of the anatomical literature (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015;Tomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016). No comprehensive systematic review of systematic reviews was performed because there was no previously-used quality assessment of anatomical studies, and the number of true evidence-based reviews and meta-analyses in the literature is limited.…”