Journal article
Vascular supply at risk during lateral release of the patella during total knee arthroplasty: A cadaveric study
Journal of clinical orthopaedics and trauma, Vol.10(1), pp.107-110
01/2019
DOI: 10.1016/j.jcot.2017.11.009
PMCID: PMC6349579
PMID: 30705542
Abstract
Lateral release to improve patellar tracking is commonly performed during total knee arthroplasty. Blood is supplied to the lateral patella by two main arteries: the superior and inferior lateral genicular arteries. The transverse infrapatellar artery also branches off the lateral inferior genicular artery to supply the inferior half of the patella. Severance of any of these arteries during lateral release can lead to avascular necrosis of the patella. This cadaveric study investigates the lateral vasculature to the patella and whether it can be visualized and preserved during lateral release of the patella.
This study involved ten cadavers, each of which underwent lateral release of the patella. One senior joint surgeon performed and supervised the incisions and attempted to locate and preserve these vessels. We then quantified the number of cadavers with visualized blood vessels and analysed their location and course to determine whether they could be preserved during lateral release of the patella.
In our study, three of the ten cadavers had an artery that was visible within the incisional plane and preserved. Two were the inferior lateral genicular artery, and one was the superior lateral genicular artery. In the other seven cadavers, no vessels were visualized during the lateral dissection.
These results demonstrate that it is difficult to visualize blood supply to the patella during lateral release. Every attempt should be made to preserve these blood vessels to avoid devascularization to patella in the setting of an already severed medial vascularity due to standard approach to knee replacement.
Details
- Title: Subtitle
- Vascular supply at risk during lateral release of the patella during total knee arthroplasty: A cadaveric study
- Creators
- Henry DeBell - University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USAZachariah Pinter - University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USAMartim Pinto - University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USAShelby Bergstresser - University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USASung Lee - University of Alabama School of Medicine, 670 University Blvd, Birmingham, AL 35233, USACesar de Cesar Netto - Department of Orthopedic Surgery, University of Alabama School of Medicine, 1313 13th Street South, Birmingham, AL 35294, USAAshish Shah - Department of Orthopedic Surgery, University of Alabama School of Medicine, 1313 13th Street South, Birmingham, AL 35294, USASameer Naranje - Department of Orthopedic Surgery, University of Alabama School of Medicine, 1313 13th Street South, Birmingham, AL 35294, USAAmit Kumar Agarwal - Department of Orthopedic Surgery, Indraprastha Apollo Hospital, New Delhi, India
- Resource Type
- Journal article
- Publication Details
- Journal of clinical orthopaedics and trauma, Vol.10(1), pp.107-110
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.jcot.2017.11.009
- PMID
- 30705542
- PMCID
- PMC6349579
- ISSN
- 0976-5662
- eISSN
- 2213-3445
- Language
- English
- Date published
- 01/2019
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040302902771
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