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During a total knee arthroplasty using a standard medial parapatellar approach, if a lateral parapatellar release is required, special attention should be made to preserve which of the following arteries?
Superior lateral genicular
Inferior lateral genicular
Anterior recurrent tibial
Descending branch of lateral femoral circumflex
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The superior lateral genicular artery is the one at greatest risk with a lateral release of the patella. After a standard medial parapatellar approach to the knee with excision of the fat pad and lateral meniscus, the superior lateral genicular artery is likely the only remaining blood supply to the patella. The review article by Kelly emphasizes that the superior lateral genicular artery should be preserved when possible with the release as it may be the last extraosseous blood supply to the patella. Resurfacing of the patella further decreases blood supply to the patella by damaging the intraosseous blood supply of the patella. Illustration A demonstrates the anastomosis network of arteries surrounding the patella.
Instr Course Lect. 2001 50:403-7. PMID: 11372340 (Link to Abstract)
Kelly, ICL 2001
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This is a video of a medial parapatellar knee arthrotomy performed for a GSW to...