Sensory conduction study of the infrapatellar branch of the saphenous nerve

Abstract

Although neuropathies of the infrapatellar nerve (infrapatellar branch of the saphenous nerve, IPBSN) have been reported clinically, no electrophysiological method has been defined to evaluate IPBSN conduction. We therefore studied a total of 60 saphenous nerves and 60 IPBSNs from 36 volunteers. The IPBSN was stimulated medially with a surface electrode 2 cm below the patella. The response was recorded with a needle electrode located close to the nerve 1 cm lateral to the femoral artery in the inguinal region. Sensory nerve action potentials were obtained from each subject; mean latency of the first positive peak was 8.1 +/- 0.9 ms, conduction velocity was 54 +/- 4.4 m/s, and response amplitude was 1.3 +/- 1.1 microV. The method that we describe may be an easy and useful electrophysiological test for neuropathies of the IPBSN.

Reference value for infrapatellar branch of saphenous nerve conduction study: Cadaveric and clinical study

“…In this cadaveric study, the IPBSN commonly gave its terminal branches in between patella and tibial tuberosity, as was demonstrated in previous cadaveric study(s) [1]. This location is 15.92 mm below inferior pole www.e-arm.org of patella in average and is consistent with a IPBSN nerve conduction study, where stimulation site is 2 cm below the patella in medial knee [3]. In addition, we measured the acute angle of the terminal branch of the IPBSN in relation to a perpendicular line to the imaginary line connecting patella and tibial tuberosity (considering the arclike course of the IPBSN).…”

“…The IPBSN runs under the sartorius muscle. After penetrating the sartorius muscle and fascia lata to become subcutaneous, it runs superficially over the anteroinferior and medial aspect of knee [1][2][3][4][5]. IPBSN is connected to the medial and intermediate femoral cutaneous nerve and lateral femoral cutaneous nerve in the proximal to the knee, and to the other branches of the saphenous nerve in the distal to the knee, to form a cutaneous network called the peripatellar plexus [6].…”

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

“…As an example, the infrapatellar branch of the saphenous nerve (IPBSN) is solely a sensory nerve that innervates the anterior and inferior parts of the knee capsule as well as the skin over the antero-medial knee [52][53][54][55][56]. Several studies (including two randomized, double-blinded, placebo-controlled trials) have examined the efficacy of a selective nerve block of the IPBSN for treatment of postoperative knee pain [57][58][59][60][61].…”

Prevalence and clinical implications of nerve injury during bone patellar tendon bone harvesting for anterior cruciate ligament reconstruction

“…The nerve itself is purely sensory, with no motor component, and it supplies the anterolateral aspect of the leg. 13 The prevalence of IPBSN injury secondary to ACL surgery varies among different studies depending on the type of incision and graft. [14][15][16] Injuries to the SN and its branches are well reported with HS graft harvest 17 but remained underreported for traditional central third patellar tendon harvesting.…”