title: Prevalence and surgical significance of a high-origin anterior tibial artery.
abstract: OBJECTIVE
  To assess the prevalence of proximal high-origin anterior tibial artery and its surgical significance.
  
  
  METHODS
  100 knees were prospectively studied using colour Doppler ultrasonography. No patient had a history of lower-limb arterial pathology or previous knee surgery. All ultrasound images were assessed by a single experienced vascular technician to eliminate inter-observer variability.
  
  
  RESULTS
  The mean age of the patients was 56 years (range, 21-96 years). Prevalence of the high-origin anterior tibial arterial pattern was 6%, greater than that reported by previous angiographic or cadaveric studies. In all patients with high-origin anterior tibial artery, the artery was in direct contact with the posterior cortex of the tibia.
  
  
  CONCLUSIONS
  This highlights the danger of using sharp instruments in knee procedures that involve extension of osteotomy to the posterior tibial cortex, particularly high-tibial osteotomy and total knee replacement. Knowledge of the anatomical variations in the branching of the popliteal artery is important because damage to its branches can be limb- or life-threatening.
authors.affiliation: Medway Maritime Hospital, Windmill Road, Gillingham, Kent, United Kingdom. alistair_tindall@hotmail.com
authors.forename: A J
authors.initials: AJ
authors.lastname: Tindall
authors.forename: A A
authors.initials: AA
authors.lastname: Shetty
authors.forename: K D
authors.initials: KD
authors.lastname: James
authors.forename: A
authors.initials: A
authors.lastname: Middleton
authors.forename: K Wk
authors.initials: KW
authors.lastname: Fernando
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D016909:Tibial Arteries / Q000002:abnormalities / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color