The anatomical study of infrapatellar branch of the saphenous nerve and design of a modified incision to decrease numbness following total knee arthroplasty
GAO Xing-hua, LIU Yong-yi, WANG Min-cong, ZHANG Guang-ming, HOU Zi-qi
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (2) : 121-125.
The anatomical study of infrapatellar branch of the saphenous nerve and design of a modified incision to decrease numbness following total knee arthroplasty
Objective To explore the infrapatellar branch of the saphenous nerve (IPBSN) that is apt to be injured during total knee arthroplasty (TKA), leading to numbness in its area of distribution, and modify the incision of TKA to decrease numbness. Methods 12 cadaveric knees were dissected, the origin of the nerve was traced in relation with the sartouius muscle and the knee anatomy mark, the course and terminal branches of the nerve were observed and recorded. Then a modified knee lateral incision for TKA was designed, and the results were collected and compared with the med-line incision group. Results The nerve was found to the emerge near the anterior border of sartorius muscle, with a distance to the medial margin of the patella being 3.2 cm. In a majority of the cases (75%), there were 3 branches between the apex of patella and tibial tuberosity; in the center of the patella tendon, a coordinate system was made, and the majority of the nerve fibers lied in the first quartile of the right knee, and in the second quartile of the left knee. 15 TKA cases were performed using the modified lateral incision. The surgery was uneventful, and the post-operation numbness rate and scope were significantly reduced than in the control group. Conclusion By enriching the knowledge of these variable anatomical position of the IPBSN, an modified lateral incision for TKA with reduced incidence of numbness is feasible and valuable.
Infrapatellar branch(IPBSN) / Total knee arthroplasty(TKA) / Numbness / Incision
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