DANGER TO THE POPLITEAL ARTERY IN HIGH TIBIAL OSTEOTOMY

We report a case in which the popliteal artery was divided during uppe r tibial osteotomy performed with the knee in 90 degrees of flexion. T his position is believed to allow it to fall safely back from the tibi a, but we could find no published confirmation. We used duplex ultraso nography in ten healthy volunteers to measure the distance from the po pliteal artery to the posterior surface of the tibia at various degree s of flexion of the knee. Our results showed that in 12 of 20 knees th e popliteal artery was closer to the tibia in 90 degrees of knee flexi on than in full extension. Surgeons performing upper tibial osteotomy should be aware that flexing the knee does not protect the popliteal a rtery from injury.