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Localization of the genicular arteries under ultrasound guidance
Anesth Pain Med 2019;14(1):67-75
Published online January 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Kyoung Hee Han , Sung Ryul Yoon , Yoo Jin Choung , Hyun Young Lim , and Jae Chol Shim
Department of Anesthesiology and Pain Meidcine, Hanyang University Seoul Hospital, Seoul, Korea
Correspondence to: Jae Chol Shim, M.D., Ph.D. Department of Anesthesiology and Pain Meidcine, Hanyang University Seoul Hospital, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea Tel: 82-2-2290-8680 Fax: 82-2-2299-8692 E-mail: jcshim@hanyang.ac.kr ORCID https://orcid.org/0000-0003-0356-8657
Received April 26, 2018; Revised June 20, 2018; Accepted June 21, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Key Words : Anatomy; Genicular artery; Knee osteoarthritis; Nerve block; Pain; Ultrasonography.


January 2019, 14 (1)
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