Relationship between posteromedial distal femur exostosis and the course of the popliteal artery in patients with multiple cartilaginous exostoses

The popliteal artery runs along the posterior surface of the distal femur. An exostosis on the posteromedial aspect of the distal femur can potentially affect the course of this artery, depending on its position and shape. This study aimed to clarify the relationship between distal femur exostoses and the course of the popliteal artery in patients with multiple cartilaginous exostoses. This study included 10 patients who underwent exostosis resection in the posteromedial aspect of the distal femur between April 2002 and March 2022. Sex, age, operated side, course of the popliteal artery relative to the exostosis, exostosis shape, recurrence rate, and perioperative complications were analyzed. Exostosis shape was classified as pedunculated or sessile based on the lateral radiographic view. The patients were divided into three groups based on the course of the popliteal artery relative to the exostosis: lateral, over, and medial. The study included eight male patients and two female patients. The mean age at operation was 12.8 years. Three patients had pedunculated lesions, and seven had sessile lesions. The popliteal artery ran laterally in six cases, over in three, and medially in one. The median follow-up period was 1.1 years. There were no cases of recurrence or major complications. The course of the popliteal artery may vary depending on the location and shape of the exostosis. Understanding this relationship preoperatively and paying attention to the artery intraoperatively are essential to prevent vascular damage.