“Descending genicular artery. branching patterns and measuring parameters: a systematic review and meta-analysis of several anatomical studies. ”

Publication date: Available online 28 March 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Thomas Ziegler, Lars-Peter Kamolz, Anna Vasilyeva, Michael Schintler, Maximilian Neuwirth, Daryousch Parvizi
BackgroundThe medial femoral condyle (MFC) flap is based on the descending genicular artery (DGA), a vessel with different variations in its course and branching patterns. Many studies have dealt with the vascular anatomy of the medial femoral condyle. However, the results of their investigations differ markedly.MethodsThe authors performed a systematic literature research in MEDLINE for articles published until May 2017 on the vascular anatomy of the descending genicular artery. After the screening, 23 relevant studies with a similar topic were included into this comprehensive analysis.ResultsThe systematic review examined the lengths and diameters of the individual arteries with regard to the vascularized bone flap of the medial femoral condyle. The descending genicular artery is present in 94% of cases with an average length of 1.8 cm. In 63% of the investigated cases it divides into 3 terminal branches. The articular branch has an average length of 7.7 cm, the saphenous branch of 10.7 cm and the muscular branch of 3.2 cm.ConclusionIn order to ensure a secured survival of this free flap, the convoluted vascular anatomy above the medial femoral condyle must be understood in detail. For the systematic classification of anatomical patterns of the DGA, we recommend the Dubois-classification.We present a summary of all anatomical studies dealing with the vascular supply of this area and the descending genicular artery to date.