Reference Value for Infrapatellar Branch of Saphenous Nerve Conduction Study: Cadaveric and Clinical Study

Kim, Keon-tae; Kim, Yong-Ki; Yoon, Jung Hwan; Ko, Yun Dam; Chung, Moonkyung

doi:10.5535/arm.2018.42.2.321

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Kim and Tran et al. [7-8] also conducted cadaver studies to determine the optimal stimulation and recording site for the IPBS nerve and similarly found that there was variability in the location of the branch. Depending on the height of the patient, this line can span many centimeters, and in order to treat the entire line, as seen in Figure 1, eight or more cycles of cryoablation need to be performed.…”

Section: Technical Reportmentioning

confidence: 99%

Identification of the Infrapatellar Branch of the Saphenous Nerve for Treatment Using a Peripheral Nerve Stimulator: A Technical Report

McLean

2019

Cureus

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The infrapatellar branch of the saphenous is becoming a common therapeutic target for the diagnosis and treatment of anterior knee pain. It is a nerve commonly injured during knee surgeries, resulting in neuroma formation and chronic neuropathic pain states, and can also transmit nociceptive input in patients with non-surgical anterior knee pain of multiple etiologies. After diagnosing infrapatellar saphenous neuralgia, the nerve is safely ablated using radiofrequency ablation, neurolytic solutions, and, most recently, cryoablation using the handheld iovera® cryoablation system (Myoscience, Inc. Fremont, CA). The iovera® technology benefits from procedural simplicity in that the nerve doesn’t specifically need to be identified and the described technique involves treating a long line over which the infrapatellar branch of the saphenous nerve is expected to course. However, there is significant variability in the course of the nerve and much of the area treated misses the actual location of the nerve, wasting time and potentially increasing patient discomfort and risk of complications. To address these limitations we endeavored to identify a way to more precisely treat the specific location of the nerve thereby optimizing treatment success and procedural simplicity. Using a MiniStim® peripheral nerve stimulator (Halyard Health, Inc., Georgia, US) to scan for the nerve along the previously described treatment line, we have been able to identify a more precise location of the nerve and optimize the treatment target area. This non-invasive identification technique has, to our knowledge, not been previously described.

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Section: Technical Reportmentioning

confidence: 99%

Identification of the Infrapatellar Branch of the Saphenous Nerve for Treatment Using a Peripheral Nerve Stimulator: A Technical Report

McLean

2019

Cureus

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Infrapatellar Nerve Dysfunction

Charalambous

2021

The Knee Made Easy

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Frequency of infrapatellar neuropathy post-total knee replacement and arthroscopic surgery in Egyptian patients

Saif

Eltabl

2020

Egypt Rheumatol Rehabil

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Background The infrapatellar branch of the saphenous nerve (IPBSN) contains only sensory fibers that innervate the knee regarding its anteromedial aspect and the anterior-inferior portion of its capsule. IPBSN damage has been recorded as a postoperative complication of surgery about the knee, which is manifested by pain, numbness and reflex sympathetic dystrophy. The incisions made for arthroscopy, medial arthrotomy, and anterior cruciate ligament surgery also, can causes IPBSN damage in about 0.5 to 30% of cases. We aimed to study the frequency of infrapatellar branches of the saphenous nerve entrapment/injured in Egyptian patients to find the incidence of its affection in post-operative knee surgeries and to increase the awareness of this condition. Results Ninety patients complaining pain at the antero-medial aspect of the knee were collected and divided into 3 groups: G1 included 30 patients with a history of total knee replacement, G2 included 30 patients with a history of knee arthroscopy and G3 included 30 patients with non-specific knee pain. All patients went to clinical, electrophysiological study and laboratory measures. There was a significant statically differences of sensory nerve conduction study regarding latency and amplitude of infrapatellar nerve between the three groups and significant statically differences of clinical signs among patients of the studied groups regarding Hofmann-Tinel sign and pain provocation test. Conclusion The entrapment/injury of IPBSN is an underestimated sometimes unrecognized cause of post-operative knee pain to many clinicians. Awareness of this condition would probably help in managing these cases to decrease post-operative pain and disability as the frequency of infrapatellar neuropathy post total knee replacement was 56.6% and post arthroscopic surgery was 63.3% in cohort of Egyptian patients.

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Reference Value for Infrapatellar Branch of Saphenous Nerve Conduction Study: Cadaveric and Clinical Study

Cited by 3 publications

References 12 publications

Identification of the Infrapatellar Branch of the Saphenous Nerve for Treatment Using a Peripheral Nerve Stimulator: A Technical Report

Identification of the Infrapatellar Branch of the Saphenous Nerve for Treatment Using a Peripheral Nerve Stimulator: A Technical Report

Infrapatellar Nerve Dysfunction

Frequency of infrapatellar neuropathy post-total knee replacement and arthroscopic surgery in Egyptian patients

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