Selection of the recipient vessel in the free flap around the knee: The superior medial genicular vessels and the descending genicular vessels

In reconstructions around the knee, the use of a free flap is indicated in a limited number of cases, but it plays a critical role in cases of extensi ve defects or unavailability of local flaps. The selection of the recipient vessel is an essential and challenging step for a successful free tissue t ransfer. Popliteal vessels and other small vessels around the knee have bee n reported to be used as recipient vessels, but the choice of recipient ves sels around the knee has not been established. In this study, after. a thor ough investigation of the vascular anatomy at the knee region, the superior medial genicular vessels and the descending genicular vessels were conside red to be the proper recipient vessels, and a clinical application was trie d. From July of 1997 to July of 1999, a total of seven cases of soft-tissue defects around the knee-four cases in the posterior region and three cases in the anterior region-were reconstructed with free flaps, using the super ior medial genicular vessels and the descending genicular vessels, respecti vely. All flaps survived completely, with no flap loss. The advantages of t hese vessels are their proximity to the knee and their reliability, versati lity, simplicity, and size match. The outstanding characteristic of this co mbination of vessels is their versatility. because the combination can cove r all defects around the knee. The clinical application and the versatility of the combination of the superior medial genicular vessels and the descen ding genicular vessels as the recipient vessels was confirmed for the recon struction of posterior and anterior knee defects.