Infrapatellar Branch of the Saphenous Nerve: Therapeutic Approaches to Chronic Knee Pain.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Current Pain and Headache Reports Pub Date : 2024-04-01 Epub Date: 2024-01-31 DOI:10.1007/s11916-024-01217-7

Alaa Abd-Elsayed, Lukas J Henjum, Barnabas T Shiferaw, Peter E Yassa, Kenneth J Fiala

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Abstract

Purpose of review: The infrapatellar branch of the saphenous nerve (IPS) is an under-investigated nerve that can be a source of chronic knee pain. This literature review aims to deliver an up-to-date review of chronic pain transmitted via the IPS along with therapeutic approaches available for pain refractory to conservative measures.

Recent findings: Knee pain transmitted via the IPS can arise from several etiologies. Damage to the IPS is often iatrogenic and develops following total knee arthroplasty, anterior cruciate ligament reconstruction, and other knee surgical procedures. Other causes of IPS-derived pain include entrapment of the nerve, neuromas, Schwannomas, and pain from knee osteoarthritis transmitted through the IPS.This article investigated therapeutic approaches to pain derived from the IPS. Common approaches included radiofrequency ablation, neuroma excisions, Schwannoma excision, nerve blocks, surgical exploration, surgical release of an entrapped nerve, cryoablation, and peripheral nerve stimulation. Pain scores, duration of pain relief, adverse events, and secondary outcomes were all included in this review. A subset of the patient population experiences chronic pain deriving from the IPS that is refractory to conservative treatment measures. This review aims to evaluate the etiologies and therapeutic approaches for chronic pain arising from the IPS refractory to conservative treatments.

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隐神经髌下分支：慢性膝关节疼痛的治疗方法。

审查目的：隐神经髌下支（IPS）是一种未得到充分研究的神经，可能是慢性膝关节疼痛的来源。这篇文献综述旨在对通过 IPS 传导的慢性疼痛进行最新综述，并介绍对保守治疗无效的疼痛可采用的治疗方法：通过 IPS 传播的膝关节疼痛可由多种病因引起。IPS 的损伤通常是先天性的，在全膝关节置换术、前交叉韧带重建术和其他膝关节外科手术后出现。导致 IPS 疼痛的其他原因包括神经卡压、神经瘤、许万瘤以及通过 IPS 传播的膝关节骨关节炎引起的疼痛。常见的方法包括射频消融、神经瘤切除、许万瘤切除、神经阻滞、手术探查、手术松解卡压神经、冷冻消融和周围神经刺激。疼痛评分、疼痛缓解持续时间、不良事件和次要结果均包括在本综述中。有一部分患者因 IPS 引起的慢性疼痛而无法接受保守治疗。本综述旨在评估对保守治疗无效的 IPS 引起的慢性疼痛的病因和治疗方法。

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来源期刊

Current Pain and Headache Reports CLINICAL NEUROLOGY-

CiteScore

6.10

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings regarding the diagnosis, treatment, and management of pain and headache. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of pain and headache. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anesthetic techniques in pain management, cluster headache, neuropathic pain, and migraine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.