Anatomy of perforating branch flap of descending genicular artery

Objective To explore anatomic features of the perforating branch of descending genicular artery,and provide a new operative method for repairing soft tissue defects around knee joint.Methods The lower edge of medial femoral condyle and the adductor tubercle were taken as the marks to dissect 40 specimens of adult lower limb perfused with red latex.The courses,branches and distributions of the perforating branches of descending genicular artery,and its anastomosis with peripheral vessels were observed under magnifying glass.Meanwhile,simulated operation was performed on one side of fresh specimen.Results Perforating branches of descending genicular artery started from the lower edge of medial femoral condyle about 4cm,and passed through the deep fascia in which the triangle depression surrounded by the vastus medialis muscle,adductor tendon and the medial femoral condyle to the subcutaneous.They also separated large number of small blood vessels,which closely aligned with the adjacent vascular network around the patella,perforating branches of the sartorius leading-edge and trailing-edge,branches of the M.C.perineural and neural stem vascular chain.Then they formed along the sartorius muscle and femoral cutaneous nerve medial longitudinal axis of the vascular plexus in the upper part of the medial.Conclusions The axial pattern flaps or cross-regional blood supply skin flap pedicled with descending genicular artery can be formed to repair nonunion and defect around knee joint.