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Review article
Submitted: 2023-12-11
Accepted: 2024-02-13
Published online: 2024-04-10
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Clinical anatomy of the popliteal artery and its implications in total knee arthroplasty: a systematic review and meta-analysis

Jakub Radosław Pękala12, Jonasz Tempski12, Eirik Krager12, Jakub Ratusznik12, Wiktor Raputa12, Izabella Świerczek12, Przemysław A. Pękala12, Jerzy A. Walocha12
·
Pubmed: 38512007
Affiliations
  1. International Evidence-Based Anatomy Working Group, Kraków, Poland
  2. Department of Anatomy Jagiellonian University Medical College, Cracow, Poland, Krakow, Poland

open access

Ahead of Print
REVIEW ARTICLES
Submitted: 2023-12-11
Accepted: 2024-02-13
Published online: 2024-04-10

Abstract

The popliteal artery (PA) is a lower extremity arterial vessel, a continuation of the superficial femoral artery. PA may be injured in the majority of total knee arthroplasty (TKA), as well as arthroscopic surgeries which may lead to acute ischemic injury. Our objective was analyzing morphometry of PA in relation to other structures both in flexion and extension of the knee, highlighting discrepancies in the PA’s location in varying positions. Literature was reviewed in regards to morphological qualities, prevalence rates, and variants of PA were pooled. Five cadaveric and 14 radiological studies were included, totalling 1473 lower limbs. We found that PA, when nearing bone, was more predictable and fixed as seen in axial plane one and two centimeters distal to joint line at 0 degrees flexion. The distance between PA and posterior tibial cortex was estimated at 3.3 mm with 95% confidence interval (CI) 2.6–4.1 and 7.8 mm (95% CI 5.1–10.5) respectively. Once PA passed over and nearing the joint it had larger discrepancies with distance comparing the knee in 0 vs 90 degree flexion.

Due to rise of TKA, arthroscopic surgeries and connected vascular complications PA has been investigated more frequently, and while majority of publications describes relationships between vessels of popliteal area and specific landmarks conducted with knee in extension, our study also implemented data regarding knee flexion thus encompassing the problem in a more dynamic manner. We believe this provides superior data for identification of PA, especially during knee surgery.

Abstract

The popliteal artery (PA) is a lower extremity arterial vessel, a continuation of the superficial femoral artery. PA may be injured in the majority of total knee arthroplasty (TKA), as well as arthroscopic surgeries which may lead to acute ischemic injury. Our objective was analyzing morphometry of PA in relation to other structures both in flexion and extension of the knee, highlighting discrepancies in the PA’s location in varying positions. Literature was reviewed in regards to morphological qualities, prevalence rates, and variants of PA were pooled. Five cadaveric and 14 radiological studies were included, totalling 1473 lower limbs. We found that PA, when nearing bone, was more predictable and fixed as seen in axial plane one and two centimeters distal to joint line at 0 degrees flexion. The distance between PA and posterior tibial cortex was estimated at 3.3 mm with 95% confidence interval (CI) 2.6–4.1 and 7.8 mm (95% CI 5.1–10.5) respectively. Once PA passed over and nearing the joint it had larger discrepancies with distance comparing the knee in 0 vs 90 degree flexion.

Due to rise of TKA, arthroscopic surgeries and connected vascular complications PA has been investigated more frequently, and while majority of publications describes relationships between vessels of popliteal area and specific landmarks conducted with knee in extension, our study also implemented data regarding knee flexion thus encompassing the problem in a more dynamic manner. We believe this provides superior data for identification of PA, especially during knee surgery.

Get Citation

Keywords

popliteal artery, total knee arthroplasty, meta-analysis, morphological variants, popliteal artery aneurysm, popliteal artery tear, arthroscopy

About this article
Title

Clinical anatomy of the popliteal artery and its implications in total knee arthroplasty: a systematic review and meta-analysis

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Review article

Published online

2024-04-10

Page views

18

Article views/downloads

15

DOI

10.5603/fm.98506

Pubmed

38512007

Keywords

popliteal artery
total knee arthroplasty
meta-analysis
morphological variants
popliteal artery aneurysm
popliteal artery tear
arthroscopy

Authors

Jakub Radosław Pękala
Jonasz Tempski
Eirik Krager
Jakub Ratusznik
Wiktor Raputa
Izabella Świerczek
Przemysław A. Pękala
Jerzy A. Walocha

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