The saphenous nerve: its course and importance in medial arthrotomy

Hunter, Letha Y.; Louis, Dean S.; Ricciardi, James R.; O'Connor, Gerald A.

doi:10.1177/036354657900700403

Cited by 115 publications

(73 citation statements)

References 2 publications

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“…Our patients' pain scores were minimal and no functional impairments were discernable; in fact the functional scores at both followups were comparable to those in a large series of patients undergoing anterior approach THA [61]. Peri-incisional dysesthesias after DAA THA may in fact be analogous to injury of the infrapatellar branch of the saphenous nerve (IPBSN) [29] in ACL reconstruction and TKA, in which numbness around the surgical wound is neither uncommon nor functionally impairing. Incidence ranges from 4% after TKA to up 88% after ACL reconstruction [1,11,34,40,45,52].…”

Section: Discussionsupporting

confidence: 59%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

205

145

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 59%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

205

145

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“…This complication is secondary to trauma induced to the sensory nerves of the anterior knee during the surgical approach. These nerve branches include the medial femoral cutaneous nerve proximally and the infrapatellar branch of the saphenous nerve distally, which is the most commonly affected branch [1,17,18]. Presumably then, an anterolateral skin incision would reduce the amount of trauma to the nerves.…”

Section: Discussionmentioning

confidence: 99%

Hypesthesia after Anterolateral versus Midline Skin Incision in TKA: A Randomized Study

Laffosse

Potapov

Malo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background The anterior midline skin incision in a TKA provides excellent surgical exposure. However, it usually requires sectioning the infrapatellar branch of the saphenous nerve which may be associated with lateral cutaneous hypesthesia and neuroma formation.Questions/purposes We asked whether an anterolateral skin incision to the knee would decrease the area of skin hypesthesia and associated postoperative discomfort. Patients and Methods We randomized 69 knees to receive a TKA through either a midline or an anterolateral skin incision. We assessed skin sensitivity by application of the Semmes-Weinstein monofilament at 13 reference points at 6 weeks and 6 and 12 months postoperatively.

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“…Most important is the mentioned year 1979 in which there might be found the next clue on our research for the SBSN. Regarding the already listed references published in 1979, there remains the paper of Hunter et al [14] In a latter publication the same image with the same distribution, infrapatellar and sartorial branch can be identified as in the manuscript of Sabat and Kumar. [2] Regarding the figure´s legend properly, it is stated to be patterned after Cunningham´s Textbook (11th Edition), [15] more precisely from an image on page 760 (Figure).…”

Section: Introductionmentioning

confidence: 89%

The “ghost” nerve alias sartorial branch of the saphenous nerve: a proof of scientific negligence!

Feigl¹,

Anderhuber²

2015

Anatomy

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The use of a valid and common terminology would be an ideal base that all medical specialties are able to correspond with and to understand each other. Latin had been the "united" language which had been used for centuries; English partially replaced this language some decades ago. As a consequence, the IFAA (International Federation on Anatomical Associations) [1] included the English terms in the "International Anatomical Terminology". Unfortunately this "terminology" is not well accepted or frequently used by clinicians. What is more, clinicians and even anatomists partially are not aware that this terminology exists. Subsequently, the denial of the existing and valid anatomical terminology leads to a creation of a "new" clinical terminology which might be different among the various fields. One of the worst cases might be that new terms are created due to lacking knowledge. However, the creation of an internationally accepted terminology is not only deserved but more desperately needed. We would like to show this problem presenting following example: the sartorial branch of the saphenous nerve (SBSN).We stepped over this SBSN during a literature research for saphenous nerve blocks for regional anaesthetic purposes. The nerve is mentioned by Sabat and Kumar.[2] The authors list the sartorial branch (SBSN) as one terminal branch, the second to be the infrapatellar branch (IPBSN AbstractMisinterpretation of terminology or new creations of anatomical terms can be observed worldwide. Occurring problems because of these invalid terms might be highlighted by an example. During a literature research concerning the saphenous nerve, the sartorial branch of the saphenous nerve was found. As this nerve does not exist in anatomical textbooks as well as in anatomical terminology, we searched for the origin of this branch. In a publication from more than 30 years ago, the reason of the creation of this odd nerve was dyslexia of some authors, reading "sartorial" instead of "saphenous". This gives reason to think about the pressure at universities to focus only on quantity and not on quality of papers. Literature research is sloppy as well as poor; the knowledge sometimes is even poorer, and in addition time to analyse the content of textbooks and papers are not taken. More dreadful is the fact that the manuscript underwent the regular review process, which indicates that the reviewer did not provide the anatomical knowledge as well. Therefore we are all, as scientist or reviewer, always required to research properly and to review only if we are sure to provide the responsibility of a correct judgement together with the anatomical background.

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The saphenous nerve: its course and importance in medial arthrotomy

Cited by 115 publications

References 2 publications

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Hypesthesia after Anterolateral versus Midline Skin Incision in TKA: A Randomized Study

The “ghost” nerve alias sartorial branch of the saphenous nerve: a proof of scientific negligence!

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