The relative contribution of the medial and lateral femoral circumflex arteries to the vascularity of the head and neck of the femur: a quantitative MRI-based assessment.

Overview

AIMS: We aimed to quantify the relative contributions of the medial femoral circumflex artery (MFCA) and lateral femoral circumflex artery (LFCA) to the arterial supply of the head and neck of the femur. MATERIALS AND METHODS: We acquired ten cadaveric pelvises. In each of these, one hip was randomly assigned as experimental and the other as a matched control. The MFCA and LFCA were cannulated bilaterally. The hips were designated LFCA-experimental or MFCA-experimental and underwent quantitative MRI using a 2 mm slice thickness before and after injection of MRI-contrast diluted 3:1 with saline (15 ml Gd-DTPA) into either the LFCA or MFCA. The contralateral control hips had 15 ml of contrast solution injected into the root of each artery. Next, the MFCA and LFCA were injected with a mixture of polyurethane and barium sulfate (33%) and their extra-and intra-arterial course identified by CT imaging and dissection. RESULTS: The MFCA made a greater contribution than the LFCA to the vascularity of the femoral head (MFCA 82%, LFCA 18%) and neck (MFCA 67%, LFCA 33%). However, the LFCA supplied 48% of the anteroinferior femoral neck overall. CONCLUSION: This study clearly shows that the MFCA is the major arterial supply to the femoral head and neck. Despite this, the LFCA supplies almost half the anteroinferior aspect of the femoral neck. Cite this article: Bone Joint J 2016;98-B:1582-8.