Vascular Anatomy and Blood Supply to the Femoral Head

The femoral head receives blood supply mostly from the MFCA, with the deep branch of this artery being the most important. The deep branch of the MFCA terminates in the group of posterior superior nutrient arteries of the femoral head. The posterior superior nutrient arteries enter the femoral head via the vascular foramina in the posterior superior and anterior superior quadrants of the femoral head and neck. In these quadrants, 80% of all femoral head vascular foramina are localized. The deep branch of the MFCA along with the terminal posterior superior nutrient arteries of the femoral head can support all, or nearly all, of the blood supply to the femoral head. Another source of blood supply, also originating from the MFCA, is the posterior inferior nutrient artery. From the anastomoses that contribute to the blood supply of the femoral head, the most important is the anastomosis with the IGA via the piriformis branch, which can also be a dominant vessel supplying the femoral head. The anterior nutrient artery of the femoral neck—originating from the lateral circumflex artery—and the obturator artery, via the artery of the ligamentum teres, constitute a minor component of the blood supply to the femoral head.