Nonoperative treatment of recalcitrant neuritis of the infrapatellar saphenous nerve: a case series

Abstract

Background Neuritis of the infrapatellar branch of the saphenous nerve can result from iatrogenic injury, entrapment, bursitis, or patellar dislocation. Currently, there is an unmet clinical need for treating refractory neuritis nonsurgically. Case presentation Three patients presented with persistent anterior knee pain caused by neuritis of the infrapatellar branch of the saphenous nerve that had got excellent but only temporary relief from steroid and local anesthetic nerve block. The neuropathic pain diagnostic Douleur Neuropathique 4 questionnaire and painDETECT questionnaire confirmed presence of neuropathic pain. After injection with 25 mg amniotic and umbilical cord particulate, the patient’s pain decreased from 7.3 before injection to 0.3 at 6 weeks postinjection. In addition, neuropathic symptoms significantly improved at 2 weeks and were not present by 6 weeks. By 63 weeks, two of the patients reported continued complete pain relief, while one patient underwent total knee replacement due to an allergy of a previously implanted unicondylar implant. Conclusions This case series suggests that amniotic and umbilical cord particulate may be a viable alternative to reduce pain in patients with neuropathic pain.

Surgical Treatment of Saphenous Nerve Injury Assisted by Plasma Rich in Growth Factors (PRGF): Lessons from a Case Report

“…Conservative management of neuropathic pain includes several types of treatment, such as oral or topical analgesics, the modification of activities of daily living, transcutaneous electrical stimulation, nerve blocks with corticosteroids and local anaesthetics, cryoneuroablation, pulsed and continuous radiofrequency [28,29], the application of particulate amniotic umbilical cord [30], and the use of platelet-rich plasma (PRP) [31][32][33][34], among others. The PRP we used was PRGF, which has a moderate concentration of platelets and is free of leucocytes and erythrocytes, and so it can be classified as a pure P-PRP [35].…”