The popliteal artery is the continuation of the femoral artery from the adductor hiatus through the popliteal fossa, where it is the deepest structure, lying on the femur, the posterior knee capsule and popliteus. It gives sural branches to the calf muscles and five genicular arteries that form the anastomotic network around the knee, then divides at the lower border of popliteus into the anterior and posterior tibial arteries.
| Origin | Continuation of the femoral artery at the adductor hiatus |
|---|---|
| Course | Descends through the popliteal fossa as its deepest structure, lying on the femur, knee capsule and popliteus, and divides at the lower border of popliteus into the anterior and posterior tibial arteries |
| Branches |
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Because it is tethered at the adductor hiatus and at the soleal arch and lies close to the back of the knee, the popliteal artery is the major artery most often injured in knee dislocation, and the genicular collaterals cannot sustain the leg if it is blocked. Every dislocated knee needs vascular assessment, with CT angiography if pulses are abnormal or the ankle-brachial index is below 0.9; revascularisation within about 6 hours is needed to avoid limb loss. The artery lies only millimetres behind the posterior capsule and is at risk during posterior capsular release and bone cuts in knee replacement. Popliteal artery entrapment syndrome affects young athletes with an abnormal relationship to gastrocnemius or popliteus.
Vascular injury occurs in a substantial minority of knee dislocations and may present with a cold, pulseless foot; urgent CT angiography and repair are needed to prevent amputation.
Compression of the artery by an abnormal medial head of gastrocnemius or popliteus causes exercise-induced calf claudication in young athletes and can lead to arterial damage if untreated.
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