Vascularity and neuroreceptors of the pes anserinus: anatomic study

Abstract

The primary aim of this work was to evaluate the neurovascular network of the pes anserinus (PA) at its tibial insertion because the PA is often used for anterior cruciate ligament (ACL) reconstruction. Four fresh cadaver knees were injected with India ink gelatin solution and the arteries that supply blood to the PA were identified; microscopic studies of vessels and nerve fibers were also performed. Superficial and deep branches of the inferior medial genicular artery contribute to an arterial arch that courses deep to the PA insertion. A widespread array of small vessels and nerve fibers penetrate the PA insertion and course along the length of the gracilis and semitendinosus tendons. Computer analysis revealed that the mean diameter of the vessels decreased from 2201 microm at the insertion to 661 microm midway along the length of the tendon (mean tendon length = 17 cm; range = 13-21 cm); the cross-sectional area of the vessels per histologic section decreased from 336.37-137.05 microm(2). This study demonstrates that the PA insertion is well vascularized and richly innervated and that these morphological features continue along the length of the tendons.