The arterial vascularization of the lateral tibial condyle: anatomy and surgical applications.
The contribution of the inferior lateral genicular artery (ILGA) and the anterior tibial recurrent artery (ATRA) in the arterial supply of the lateral tibial condyle (LTC) has not been comprehensively studied and remains controversial. Eleven knee joints were injected with colored latex and the arteries were dissected macroscopically. The ATRA yielded several osseous branches supplying the tibial metaphysis and the anterior part of the tibial epiphysis and several rami supplying the anterior tibial tuberosity and the lower part of the patellar tendon. The ILGA ran under the lateral collateral ligament and had a horizontal direction towards the retro-patellar fat pad. The ILGA yielded 4-6 branches ascending or descending perpendicularly to its main direction. Full anastomoses between branches derived from the ATRA and the ILGA were observed in front and behind the lateral intercondylar tubercle in all the specimens, but each vessel seemed to provide predominantly the blood supply to a specific area. The anterior part of the LTC drew its blood supply from the ATRA, the posterior part from the ILGA and the mid-portion from both arteries. The standard anterolateral approach to LTC fractures with sub-meniscal arthrotomy appears particularly harmful to epiphyseal vascularization since it interrupts many of the branches deriving from the ILGA and ATRA. The recent development of arthroscopy in the treatment of LTC fractures may be particularly advantageous as it spares the vascularization of the LTC.
Hannouche
Didier
D
Service de Chirurgie Orthopédique et Traumatologique, Hôpital André Mignot, Versailles, France. didier.hannouche@lrb.ap-hop-paris.fr
Duparc
Fabrice
F
Beaufils
Philippe
P
D000368:Aged; D001158:Arteries / Q000033:anatomy & histology / Q000601:surgery; D002102:Cadaver; D004838:Epiphyses / Q000098:blood supply; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000098:blood supply*; D008297:Male; D013977:Tibia / Q000098:blood supply*