• Glenn E Woodworth, Jason Trujillo, Erik Foss, and Michael Semenza.
• Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR 97239, USA. Electronic address: woodworg@ohsu.edu.
• J Clin Anesth. 2016 Nov 1; 34: 540-6.

Study ObjectiveTo determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa.DesignProspective, observational study.SettingUniversity medical center.SubjectsOne hundred patients scheduled for magnetic resonance imaging scans of the knee.MeasurementsBMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point.Main ResultsAt the distal femur, the tibial nerve was a mean of 2.9 mm from the popliteal artery. The nerve was consistently posterior to the artery; however, it was variably located medial or lateral to the artery. At the 5- and 8-cm measurement points, the nerve was 10.0 and 16.1 mm (SD, 4.1 and 5.2 mm), and 31° and 44° (SD, 15° and 16°) lateral to the popliteal artery, respectively. Zero degree was defined as directly posterior to the artery. Increasing BMI was correlated with increasing distance between the nerve and the artery at the 5- and 8-cm measurement points (r= 0.36 P> |t| .000 and .45 P> |t| .002).ConclusionsAt 5 cm proximal to the distal femoral condyles, the popliteal artery is a reliable sonographic landmark to locate the tibial nerve due to the close proximity and consistent location of the nerve 1 cm posterolateral to the artery, with only a moderate effect of BMI.Copyright © 2016 Elsevier Inc. All rights reserved.

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