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Cruciate Anastomosis of the Hip

anastomosis cruciformis coxae

The cruciate anastomosis is the rich vascular network around the proximal femur formed by the union of the medial and lateral femoral circumflex arteries with the inferior gluteal artery superiorly and the first perforating branch of the profunda femoris inferiorly. It supplies the posterior and inferior hip capsule, the proximal femur, and the proximal thigh, and provides collateral circulation when individual vessels are compromised.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The cruciate anastomosis is the collateral network that maintains proximal femur viability when the medial femoral circumflex artery is occluded in femoral neck fracture. The retinacular arteries supplying the femoral head arise from the MFCA via the posterior circumflex branches; when the MFCA is torn in displaced femoral neck fractures, the cruciate anastomosis cannot reliably reach the femoral head retinacular vessels, resulting in avascular necrosis. In proximal femoral arterial injury, the cruciate anastomosis maintains distal thigh perfusion.

Pathology

Common Injuries & Conditions

Disruption of Cruciate Anastomosis in Hip Arthroplasty

Posterior approach hip arthroplasty divides the short external rotators and their associated vessels from the MFCA/cruciate anastomosis; meticulous repair of the posterior capsule and rotators restores vascular coverage of the implant and reduces the risk of posterior dislocation and heterotopic ossification.