Anesth Pain Med.  2019 Jan;14(1):67-75. 10.17085/apm.2019.14.1.67.

Localization of the genicular arteries under ultrasound guidance

Affiliations
  • 1Department of Anesthesiology and Pain Meidcine, Hanyang University Seoul Hospital, Seoul, Korea. jcshim@hanyang.ac.kr

Abstract

BACKGROUND
The genicular arteries (GAs) can be utilized for genicular nerve block. We aimed to evaluate the ability to localize GAs under ultrasound in patients with chronic knee pain.
METHODS
Twenty-four knees from 14 osteoarthritic patients were enrolled. The target GAs included the superomedial GA (SMGA), superolateral GA (SLGA), and inferomedial GA (IMGA). GAs were observed at the relevant adductor tubercle and epicondyle-shaft transition under ultrasound. Distribution of the SMGA at the adductor tubercle was evaluated using defined zones in transverse and longitudinal ultrasound images. SLGA and IMGA were also categorized using defined zones in longitudinal images. Distance from bony cortex to the relevant GA was then estimated.
RESULTS
Among 24 knees, 91.7% of SMGAs were located at the upper part of the adductor tubercle. The distances between the SMGA and bony cortex on transverse view (dSMGAt) and on longitudinal view (dSMGAl) were directly correlated (rs = 0.6539, P = 0.0005).
CONCLUSIONS
Under ultrasound guidance, the SMGA was found to be mainly localized to the upper part of the adductor tubercle. Likewise, the SLGA and IMGA were mainly localized at the distal and proximal parts of the epicondyle-shaft transition, respectively. Our results support the feasibility of ultrasound guidance for GA localization in patients with knee osteoarthritis.

Keyword

Anatomy; Genicular artery; Knee osteoarthritis; Nerve block; Pain; Ultrasonography

MeSH Terms

Arteries*
Humans
Knee
Nerve Block
Osteoarthritis, Knee
Ultrasonography*
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