Introduction: Although rare, injuries to the popliteal artery are one of the most morbid complications in orthopedics, with severe sequelae. These injuries occur more frequently in previously injured extremities. We aim to quantify the relationship of the popliteal artery to the distal femur and proximal tibia using CTA in patients with and without a history of lower extremity trauma.

Methods: All patients with CTA of lower extremities over three years at a single institution were reviewed. The patients were split into two groups: a control group with no history of injury and a study group with a history of lower extremity injury about the knee at least one month prior to presentation. Exclusion criteria were history of vascular injury, or femoral shaft, distal femur, proximal tibia, or tibial shaft fractures within one month of presentation. Artery location was measured using a line tangential to the posterior tibial and femoral condyles, and the midline of the joint by a single author.

Results: 99 patients met inclusion: 18 traumatic and 81 atraumatic. In the study group, the average location of the popliteal artery was more posterior than the control group in relation to the femur (6.0mm vs. 1.4mm; p=0.001) and the tibia (4.8mm vs. 3.2mm; p=0.021). There was no difference in the lateral location of the artery when comparing the study group to the control group in relation to the femur (3.7mm vs. 4.1mm; p=0.574) or the tibia (3.5mm vs. 4.5mm; p=0.356).

Conclusion: In a posttraumatic knee, the popliteal artery is displaced posteriorly while the lateral location does not significantly change.