Genicular Anastomosis

rete articulare genus

The genicular anastomosis (articular rete of the knee) is the arterial network formed by the five geniculate arteries, the descending geniculate artery, the anterior tibial recurrent artery, and the circumflex fibular artery around the patella and knee capsule. This anastomosis maintains knee perfusion when any single geniculate vessel is occluded.

Region: Knee

Clinical Relevance

Clinical Notes

The genicular anastomosis provides collateral circulation during popliteal artery occlusion and is the basis for geniculate artery embolisation (GAE) for knee osteoarthritis pain. GAE selectively reduces synovial hypervascularity via the geniculate network while preserving overall joint perfusion through the anastomosis. In total knee arthroplasty, multiple geniculate vessels are divided but the anastomosis maintains patellar and capsular vascularity.

Pathology

Common Injuries & Conditions

Patellar Avascular Necrosis Post-TKA

Disruption of the genicular anastomotic patellar blood supply during total knee arthroplasty from lateral retinacular release, medial parapatellar arthrotomy, and fat pad excision, risking patellar osteonecrosis in extensive releases.