The Surgical Anatomy of the Infrapatellar Branch of the Saphenous Nerve in Relation to Incisions for Anteromedial Knee Surgery

ALA (Anton) Kerver, Mandala Leliveld, Dennis den Hartog, Michiel Verhofstad, Gert-jan Kleinrensink

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88 Citations (Scopus)

Abstract

Background: latrogenic injury to the infrapatellar branch of the saphenous nerve is a common complication of surgical approaches to the anteromedial side of the knee. A detailed description of the relative anatomic course of the nerve is important to define clinical guidelines and minimize iatrogenic damage during anterior knee surgery. Methods: In twenty embalmed knees, the infrapatellar branch of the saphenous nerve was dissected. With use of a computer-assisted surgical anatomy mapping tool, safe and risk zones, as well as the location-dependent direction of the nerve, were calculated. Results: The location of the infrapatellar branch of the saphenous nerve is highly variable, and no definite safe zone could be identified. The infrapatellar branch runs in neither a purely horizontal nor a vertical course. The course of the branch is location-dependent. Medially, it runs a nearly vertical course; medial to the patellar tendon, it has a 45 distal-lateral course; and on the patella and patellar tendon, it runs a close to horizontal-lateral course. Three low risk zones for iatroge Conclusions: The infrapatellar branch of the saphenous nerve is at risk for iatrogenic damage in anteromedial knee surgery, especially when longitudinal incisions are made. There are three low risk zones for a safer anterior approach to the knee. The direction of the infrapatellar branch of the saphenous nerve is location-dependent. To minimize iatrogenic damage to the nerve, the direction of incisions should be parallel to the direction of the nerve when technically possible.
Original languageUndefined/Unknown
Pages (from-to)2119-2125
Number of pages7
JournalJournal of Bone and Joint Surgery-American Volume
Volume95A
Issue number23
DOIs
Publication statusPublished - 2013

Research programs

  • EMC MUSC-01-47-01
  • EMC ONWAR-01-94-01

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