The superficial anterior vasculature of the knee is variably described; most of our information comes from anatomical literature. Descriptions commonly emphasise medial-dominant genicular branches of the popliteal artery. Describing the relative contribution of medial and lateral vessels to the anastomotic network of the anterior knee may help provide grounds for selecting one of a number of popular incisions for arthrotomy.

The aim of this study is to describe the relative contribution of vessels to anastomoses supplying the anterior knee.

Cadaveric knees (n = 16) were used in two cohorts. The first cohort (n = 8) were injected at the popliteal artery with a single colour of latex, and then processed through a modified diaphanisation technique (chemical tissue clearance) before final dissection and analysis. This was repeated for the second cohort, but with initial dissection to identify potential source vessels at their origin. Each source vessel was injected with a different colour of latex. The dominant sources were determined in each specimen.

The majority of the specimens (n = 13; 81%) demonstrated that an intramuscular branch though the vastus medialis muscle was the dominant vessel. Anastomoses were most common over the medial side of the knee, both superiorly and inferiorly (3-5 anastomoses in all cases). Anastomosis over the lateral knee was infrequent (1 anastomosis in 1 specimen).

The results suggest that anterior vasculature of the knee is predominately medial in origin, but not from the genicular branches as previously described. This network of vessels found in the anterior knee is thought to be the main supply to the patella, extensor apparatus, anterior joint capsule and skin.

Optimum placement of incision for arthrotomy is a subject of debate. Considering the main blood supply to the anterior knee may help in choosing a particular approach.