The reconstruction of soft tissue defects around the knee joint is often challenging for plastic and orthopedic surgeons. Well-vascularized tissue is required to ensure wound healing in such cases. Various alternatives, including local cutaneous flaps, fasciocutaneous flaps, muscle flaps, and free flaps, have been reported. In this article, we report the case of an 87-year-old female in whom a reverse-flow anterolateral thigh ( ALT ) flap was used to cover a soft tissue defect of the anterior knee ( the left knee ), which had become infected after a total knee arthroplasty procedure. The perforators of ALT flaps exhibit many anatomical variations, so we used ultrasonography and assessed the skin perforators of the ALT flap and the anastomosis between the descending branch of the lateral circumflex femoral artery and superior lateral genicular artery, which helped us to harvest the flap safely. The reverse-flow ALT flap is a reliable, effective, and durable option for reconstructing soft tissue defects around the knee.
