Cadaveric study of the infrapatellar branch of the saphenous nerve: Can damage be prevented in total knee arthroplasty?

Sung R Lee; Nicholas J.P Dahlgren; Jackson R Staggers; Cesar de Cesar Netto; Amit Agarwal; Ashish Shah; Sameer Naranje

doi:10.1016/j.jcot.2018.03.005

Back

Cadaveric study of the infrapatellar branch of the saphenous nerve: Can damage be prevented in total knee arthroplasty?

Journal article

Open access

Peer reviewed

Cadaveric study of the infrapatellar branch of the saphenous nerve: Can damage be prevented in total knee arthroplasty?

Sung R Lee, Nicholas J.P Dahlgren, Jackson R Staggers, Cesar de Cesar Netto, Amit Agarwal, Ashish Shah and Sameer Naranje

Journal of clinical orthopaedics and trauma, Vol.10(2), pp.274-277

03/2019

DOI: 10.1016/j.jcot.2018.03.005

PMCID: PMC6383043

PMID: 30828192

Files and links (1)

url

https://doi.org/10.1016/j.jcot.2018.03.005View

Published (Version of record) Open Access

Abstract

The infrapatellar branch of the saphenous nerve (IPBSN) is a purely sensory nerve innervating the anteromedial aspect of the knee and anteroinferior knee joint capsule. Total knee arthroplasty (TKA) is commonly used to treat end-stage arthritis, but the IPBSN is often injured and results in numbness around the anteromedial knee. The aim of this cadaveric study was to describe the course and variability of the IPBSN and to assess whether it is possible to preserve during a standard midline surgical approach in TKA. Ten fresh-frozen cadaver legs were dissected using a midline approach to the knee. Skin and subcutaneous flap were reflected to expose both the saphenous nerve and its branches. The branches of the IPBSN were identified, and their vertical distances above the tibial tuberosity (TB) were recorded: TB to inferior branch, to middle branch, and to superior branch. There were 10 left-sided specimens (6 female, 4 male) with a mean age of 79.9 ± 9.8 years. 8 (80%) specimens had 2 branches of IPBSN while 2 (20%) specimens had 3 branches. The average distance from TB to the inferior branch was 16.8 ± 8.3 mm (3.0–28.0); middle branch, 24.0 ± 1.4 mm (23.0–24.9); and superior, 45.9 ± 7.7 mm (32.0–54.5). Our cadaveric study found no consistent way to preserve the IPBSN using a standard midline approach in TKA. It is important to provide proper patient education on this complication, and surgeons should be aware of approximate locations and variations of IPBSN while performing other knee procedures.

Nerve injury

Paresthesia numbness

Total knee arthroplasty

Cadaver study

Infrapatellar branch

Saphenous nerve

Details

Title: Subtitle: Cadaveric study of the infrapatellar branch of the saphenous nerve: Can damage be prevented in total knee arthroplasty?
Creators: Sung R Lee - School of Medicine, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA
Nicholas J.P Dahlgren - School of Medicine, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA
Jackson R Staggers - School of Medicine, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA
Cesar de Cesar Netto - Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13th Street S., Birmingham, AL 35205, USA
Amit Agarwal - Institutes of Orthopaedics, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi Mathura Road, New Delhi 110076, India
Ashish Shah - Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13th Street S., Birmingham, AL 35205, USA
Sameer Naranje - Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13th Street S., Birmingham, AL 35205, USA
Resource Type: Journal article
Publication Details: Journal of clinical orthopaedics and trauma, Vol.10(2), pp.274-277
Publisher: Elsevier B.V
DOI: 10.1016/j.jcot.2018.03.005
PMID: 30828192
PMCID: PMC6383043
ISSN: 0976-5662
eISSN: 2213-3445
Language: English
Date published: 03/2019
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040455002771

Metrics

20 Record Views

See more details