Surgical and Radiologic Anatomy

, Volume 40, Issue 7, pp 823–828 | Cite as

Quantitative analysis of the perimeniscal position of the inferior lateral genicular artery (ILGA): magnetic resonance imaging study

  • Jiwon Park
  • Sang Soo Lee
  • Tae Woo KimEmail author
Original Article



The inferior lateral genicular artery (ILGA) passes around the lateral knee joint, adjacent to the lateral meniscus (LM). ILGA injuries in total knee arthroplasty or arthroscopic surgery can result in recurrent hemarthrosis or painful pseudoaneurysms. Detailed information about the perimeniscal position of the ILGA relative to the LM is necessary to avoid these complications.


3-T MR images of 100 knees (mean age 36.3 ± 11.2 years) were retrospectively reviewed. The perimeniscal area was divided into four regions: the anterior, middle, popliteal hiatus, and posterior zones. In each zone, the ILGA diameter, superoinferior position (assessed as the height of the ILGA from the LM base), and distance between the meniscocapsular junction and the ILGA were measured.


The distance between the ILGA and meniscocapsular junction was significantly smaller in the middle zone than in the other three zones (anterior 5.3 ± 0.8 mm, middle 1.4 ± 0.4 mm, popliteal hiatus 6.1 ± 1.0 mm, and posterior 5.6 ± 1.5 mm, p < 0.05). In the superoinferior position, the height of the ILGA was 3.4 ± 0.9 mm in the anterior zone, 0.4 ± 1.3 mm in the middle zone, − 1.9 ± 1.8 mm in the popliteal hiatus zone, and − 1.3 ± 4.3 mm in the posterior zone. When the LM bottom is the base, the ILGA was located superiorly in the anterior zone, close to the base in the middle zone, and inferiorly in the popliteal hiatus zone.


To avoid ILGA injury, close attention is necessary during surgical procedures involving the meniscocapsular junction of the LM, especially at the meniscal base in the middle zone.


Lateral inferior genicular artery Anatomy Perimeniscal position Magnetic resonance imaging 


Author contributions

Kim: protocol development, data analysis, manuscript editing. Park: data collection, data analysis, manuscript writing. Lee: data collection, data analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Becher C, Burger UL, Allenberg JR, Kaufmann GW, Thermann H (2008) Delayed diagnosis of a pseudoaneurysm with recurrent hemarthrosis of the knee joint. Knee Surg Sports Traumatol Arthrosc 16:561–564. CrossRefPubMedGoogle Scholar
  2. 2.
    Bloecker K, Englund M, Wirth W, Hudelmaier M, Burgkart R, Frobell RB, Eckstein F (2011) Revision 1 size and position of the healthy meniscus, and its correlation with sex, height, weight, and bone area—a cross-sectional study. BMC Musculoskelet Disord 12:248. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Cunningham RB, Mariani EM (2001) Spontaneous hemarthrosis 6 years after total knee arthroplasty. J Arthroplast 16:133–135. CrossRefGoogle Scholar
  4. 4.
    de Carvalho RT, Ramos LA, Novaretti JV, Ribeiro LM, Szeles PR, Ingham SJ, Abdalla RJ (2016) Relationship between the middle genicular artery and the posterior structures of the knee: a cadaveric study. Orthop J Sports Med 4:2325967116673579. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Evans JD, de Boer MT, Mayor P, Rees D, Guy AJ (2000) Pseudoaneurysm of the medial inferior genicular artery following anterior cruciate ligament reconstruction. Ann R Coll Surg Engl 82:182–184PubMedPubMedCentralGoogle Scholar
  6. 6.
    Filho ES, Isolani GR, Baracho FR, de Oliveira Franco AP, Ridder Bauer LA, Namba M (2015) Pseudoaneurysm after arthroscopic procedure in the knee. Rev Bras Ortop 50:131–135. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Jo CH, Yoon KS, Lee JH, Kang SB, Lee JH, Han HS, Rhee SH, Lee MC (2009) Under-meniscal portal: an alternative portal for an easy access to the medial and lateral menisci. Knee Surg Sports Traumatol Arthrosc 17:1344–1346. CrossRefPubMedGoogle Scholar
  8. 8.
    Katsimihas M, Robinson D, Thornton M, Langkamer VG (2001) Therapeutic embolization of the genicular arteries for recurrent hemarthrosis after total knee arthroplasty. J Arthroplast 16:935–937. CrossRefGoogle Scholar
  9. 9.
    Kim JM, Bin SI, Kim E (2009) Inframeniscal portal for horizontal tears of the meniscus. Arthroscopy 25:269–273. CrossRefPubMedGoogle Scholar
  10. 10.
    Lamo-Espinosa JM, Llombart Blanco R, Valenti JR (2012) Inferior lateral genicular artery injury during anterior cruciate ligament reconstruction surgery. Case Rep Surg 2012:457198.
  11. 11.
    Lazaro LE, Cross MB, Lorich DG (2014) Vascular anatomy of the patella: implications for total knee arthroplasty surgical approaches. Knee 21:655–660. CrossRefPubMedGoogle Scholar
  12. 12.
    Lee KB, Song SY, Kwon DJ, Shin J, Paik SH (2009) Pseudoaneurysm of the medial superior genicular artery after arthroscopic partial meniscectomy. Clin Orthop Surg 1:173–175. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Maheshwari R, Kelley SP, Langkamer VG, Loveday E (2004) Spontaneous recurrent haemarthrosis following unicompartmental knee arthroplasty and its successful treatment by coil embolisation. Knee 11:413–415. CrossRefPubMedGoogle Scholar
  14. 14.
    Mello W, de Brito WE, Migon EZ, Borges A (2011) Pseudoaneurysm of the medial inferior genicular artery after anterior cruciate ligament reconstruction. Arthroscopy 27:442–445. CrossRefPubMedGoogle Scholar
  15. 15.
    Mufty S Jr, Smits P, Feyen J (2011) Pseudoaneurysm of the superior medial genicular artery following knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 19:1314–1315. CrossRefPubMedGoogle Scholar
  16. 16.
    Nomura E, Hiraoka H, Sakai H (2016) Spontaneous recurrent hemarthrosis of the knee: a report of two cases with a source of bleeding detected during arthroscopic surgery of the knee joint. Case Rep Orthop 2016:1026861.
  17. 17.
    Oversier LMR, Corten B, Barten DG, Elshof JWM (2017) Pseudoaneurysm of the superior lateral genicular artery following anterior cruciate ligament repair. Acta Chir Belg 1–6.
  18. 18.
    Pritsch T, Parnes N, Menachem A (2005) A bleeding pseudoaneurysm of the lateral genicular artery after total knee arthroplasty—a case report. Acta Orthop 76:138–140. CrossRefPubMedGoogle Scholar
  19. 19.
    Puig J, Perendreu J, Fortuno JR, Branera J, Falco J (2007) Transarterial embolization of an inferior genicular artery pseudoaneurysm with arteriovenous fistula after arthroscopy. Korean J Radiol 8:173–175. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Saini P, Meena S, Malhotra R, Gamanagatti S, Kumar V, Jain V (2013) Pseudoaneurysm of the superior lateral genicular artery: case report of a rare complication after total knee arthroplasty. Patient Saf Surg 7:15. CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Shahid S, Saghir N, Cawley O, Saujani S (2015) A cadaveric study of the branching pattern and diameter of the genicular arteries: a focus on the middle genicular artery. J Knee Surg 28:417–424. CrossRefPubMedGoogle Scholar
  22. 22.
    Tat-Sing Law M, McClure DN (2010) Therapeutic embolization in the treatment of recurrent haemarthrosis following knee arthroplasty. ANZ J Surg 80:247–249. CrossRefPubMedGoogle Scholar
  23. 23.
    Tsubosaka M, Matsushita T, Kuroda R, Matsumoto T, Kurosaka M (2015) Pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. PubMedCrossRefGoogle Scholar
  24. 24.
    Vincent GM, Stanish WD (1990) False aneurysm after arthroscopic meniscectomy. A report of two cases. J Bone Jt Surg Am 72:770–772CrossRefGoogle Scholar
  25. 25.
    Weidner ZD, Hamilton WG, Smirniotopoulos J, Bagla S (2015) Recurrent hemarthrosis following knee arthroplasty treated with arterial embolization. J Arthroplast 30:2004–2007. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopedic SurgerySeoul National University Bundang HospitalSeongnam-siSouth Korea
  2. 2.Department of Orthopaedic SurgeryHallym University Chuncheon Sacred Heart HospitalChuncheon-siSouth Korea

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