Popliteal vessels in knee surgery - A magnetic resonance imaging study

Popliteal artery injury during surgery of the knee is rare but can have dev astating consequences. The position of knee flexion has been thought to be protective fur the popliteal artery, allowing it to fall hack from the knee joint. No prior study has provided in vivo cross sectional evidence of the behavior of the popliteal vessels during knee flexion with the effect of g ravity. Magnetic resonance imaging was used in nine volunteers to measure t he distance of the popliteal artery and veins from the posterior proximal t ibia at two levels corresponding to the levels of osteotomy in total knee a rthroplasty and in high tibial osteotomy, Seams were taken with the knee in full extension and at 90 degrees flexion with the patient in the supine po sition, allowing for the effect of gravity. Considerable variation in behav ior of the vein and the artery was observed at the high tibial osteotomy cr oss sectional level and the total knee arthroplasty cross sectional level, In two knees at the high tibial osteotomy cross sectional level and in two knees at the total knee arthroplasty cross sectional, level the artery move d closer to the posterior tibia with knee flexion, Even with the effect of gravity included, knee flexion does not guarantee removal of the popliteal vessels from potential harm during surgery of the knee.