Aesthetic Plastic Surgery

, Volume 39, Issue 5, pp 752–756 | Cite as

Proximally Based Anterolateral-Thigh (ALT) Flap for Knee Reconstruction: An Advancement Propeller Perforator Flap

  • Pierfrancesco Cadenelli
  • Daniele Bordoni
  • Stefano Radaelli
  • Andrea MarchesiEmail author
Case Report General Reconstruction



Adequate coverage of the knee region is often challenging for plastic and orthopedic surgeons. In the last decade, among several reconstructive techniques, local perforator flaps have become useful reconstructive units. After a wide resection for soft-tissue sarcoma, the knee vascular web may be reasonably damaged and, consequently, perforator flaps based on a local pedicle [such as the distally based anterolateral thigh (ALT) flap] are not reliable. Thus, we harvested a proximally based ALT for knee coverage.


A 52-year-old man underwent local radiation therapy and a wide resection of a soft-tissue sarcoma on the anterior-lateral aspect of the left knee, which resulted in a 15 × 10 cm defect. The defect was covered with a proximally based ALT, through an advancement and propeller relocation of its skin paddle.


All margins were tumor free. After 5 days, the donor site was closed primarily because of edema. Neither necrosis of the flap nor dehiscence of the wound was detected. No local relapses were detected at 6-month follow-up.


In case of soft-tissue defects of the knee region, with likely involvement of the local vascular web, a local perforator solution is the advancement and propeller proximally based ALT flap.

Level of Evidence V

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Sarcoma Knee Soft tissue Reconstruction ALT Perforator flap 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2015

Authors and Affiliations

  • Pierfrancesco Cadenelli
    • 1
  • Daniele Bordoni
    • 1
  • Stefano Radaelli
    • 2
  • Andrea Marchesi
    • 3
    Email author
  1. 1.Plastic Surgery UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  2. 2.Sarcoma Service, Department of SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  3. 3.Department of Plastic and Reconstructive Surgery. IRCCS Policlinico San DonatoUniversità degli Studi di MilanoMilanItaly

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