Descending Genicular Artery

arteria genus descendens

The descending genicular artery arises from the femoral artery in the adductor canal just before the vessel passes through the adductor hiatus. It immediately divides into articular branches contributing to the geniculate anastomosis around the knee and a saphenous branch accompanying the saphenous nerve through the vastoadductor membrane to supply the medial skin of the lower thigh and knee.

Region: Thigh

Clinical Relevance

Clinical Notes

The descending genicular artery is the principal vessel at risk during medial approach exposures of the distal femur and the medial knee, including medial femoral condyle osteotomy, distal femoral plating, and VMO-splitting approaches to the patellofemoral joint. The saphenous branch accompanies the saphenous nerve, and both are at risk during adductor canal saphenous nerve blocks. The descending genicular artery flap, based on this vessel, provides a pedicled fasciocutaneous option for reconstruction around the knee.

Pathology

Common Injuries & Conditions

Descending Genicular Artery in Distal Femur Surgery

Medial approaches to the distal femur for distal femoral plating or medial femoral condyle fracture fixation encounter the descending genicular artery just above the medial femoral condyle; inadvertent division causes brisk bleeding that requires individual vessel ligation and may contribute to post-operative haemarthrosis.