Aberrant anterior tibial artery on knee MRI: A case report advocating for routine search of this anatomical variant.

An aberrant anterior tibial artery is an anatomical variant in which the anterior tibial artery arises anomalously from the popliteal artery and takes an atypical anterior course relative to the popliteus muscle. We report a case of a 56-year-old male who underwent a routine knee MRI following trauma to evaluate for a suspected meniscal tear. MRI revealed an incidental finding of an aberrant anterior tibial artery coursing anterior to the popliteus muscle and near the posterior tibial cortex. Knowledge of this variant is crucial to avoid potential iatrogenic vascular injury during orthopedic surgery, especially in procedures involving the proximal posterior tibia, such as high tibial osteotomy, total knee arthroplasty, fracture surgery, lateral meniscal repair, or posterior cruciate ligament reconstruction.