scholarly journals Surgical treatment outcome of painful traumatic neuroma of the infrapatellar branch of the saphenous nerve during total knee arthroplasty

2021 ◽  
Vol 12 (12) ◽  
pp. 1008-1015
Author(s):  
Byron Chalidis ◽  
Dimitrios Kitridis ◽  
Panagiotis Givissis
Keyword(s):  
Total Knee Arthroplasty ◽  
Treatment Outcome ◽  
Surgical Treatment ◽  
Knee Arthroplasty ◽  
Saphenous Nerve ◽  
Traumatic Neuroma ◽  
Infrapatellar Branch ◽  
Total Knee

scholarly journals Neuroma of the Infrapatellar branch of the saphenous nerve following Total knee Arthroplasty: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yongbo Xiang ◽  
Zeng Li ◽  
Peng Yu ◽  
Zhibo Zheng ◽  
Bin Feng ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Skin Incision ◽  
Saphenous Nerve ◽  
Pathological Examination ◽  
Infrapatellar Branch ◽  
Total Knee ◽  
Local Anesthetic Injection ◽  
Pathological Report

Abstract Background Injury to the infrapatellar branch of the saphenous nerve (IBSN) is common during total knee arthroplasty (TKA) with a standard midline skin incision. Occasionally, painful neuromas form at the transection of nerve and cause pain and limitation of the range of motion of the knee joint. Case presentation A 70-year-old woman experienced right knee pain and stiffness for 4 years after TKA. Physical assessment revealed medial tenderness; Tinel’s sign was positive. Radiographs revealed that the prosthesis was well-placed and well-fixed. She was diagnosed with arthrofibrosis and possible neuroma after TKA. She underwent right knee exploration, neurectomy, adhesiolysis and spacer exchange. The neuroma-like tissue was sent for pathological examination. The patient recovered uneventfully and at 3-month follow-up reported no recurrence of pain or stiffness. The pathological report confirmed the diagnosis of neuroma. Conclusions IBSN injury should be a concern if surgeons encounter a patient who has pain and stiffness after TKA. Tinel’s sign, local anesthetic injection, MRI and ultrasound could help the diagnosis and identify the precise location of neuroma. Surgical intervention should be performed if necessary.

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

2019 ◽  
Vol 10 (2) ◽  
pp. 274-277 ◽  
Author(s):  
Sung R. Lee ◽  
Nicholas J.P. Dahlgren ◽  
Jackson R. Staggers ◽  
Cesar de Cesar Netto ◽  
Amit Agarwal ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Saphenous Nerve ◽  
Cadaveric Study ◽  
Infrapatellar Branch ◽  
Total Knee

scholarly journals Postoperative numbness of the knee following total knee arthroplasty

2013 ◽  
Vol 95 (8) ◽  
pp. 565-568 ◽  
Author(s):  
R Black ◽  
C Green ◽  
D Sochart
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Saphenous Nerve ◽  
Hot Water ◽  
Water Bottle ◽  
Full Thickness ◽  
Lateral Aspect ◽  
Consent Procedure ◽  
Infrapatellar Branch ◽  
Total Knee

Introduction The infrapatellar branch of the saphenous nerve is often injured during total knee arthroplasty (TKA), leading to numbness in its distribution distal to the incision. This is illustrated in a patient who suffered full-thickness burns to the lateral aspect of the knee from a hot water bottle. However, the proportion of patients who are informed of this phenomenon (as well as the effect of informing the patient of numbness) has not previously been studied according to the authors’ knowledge. The aim of this study was to establish the proportion of patients with whom postoperative numbness was discussed during the consent procedure and whether this discussion was documented. Methods A total of 73 patients (103 TKAs) agreed to take part in this study between 16 May and 9 July 2011. Patients were asked about their recollection of numbness being mentioned prior to the procedure as well as whether they experienced postoperative numbness. Statistical analysis was performed using SPSS®. Results Subjective numbness was noted in 27% of the patients in this study. The prevalence of numbness decreased with time. Patients whose consent process included a discussion of numbness were 3.3 times more likely to report numbness after TKA (p=0.003). Conclusions Patient education regarding postoperative numbness increases the patient’s awareness of any insensate skin that may develop. Numbness after TKA does improve with time but does not resolve completely. It is therefore recommended by the authors that numbness is discussed preoperatively with the patient and that this discussion is documented.

scholarly journals Comparative study between continuous adductor canal block and intravenous morphine for postoperative analgesia in total knee arthroplasty

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Hithem Mohammed Gamil Mohammed Ali ◽  
Bassel Mohammed Essam Nour Eldin ◽  
Heba Abd Elazim Labib Ahmed ◽  
Ramy Mounir Wahba Gobran ◽  
Diaa Eldin Mahmoud Heiba
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Quadriceps Muscle ◽  
Saphenous Nerve ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Intravenous Morphine ◽  
Group A ◽  
Total Knee

Abstract Background Postoperative pain after total knee arthroplasty (TKA) is known to range from moderate (30% of patients) to severe (60% of patients). Inadequate management for postoperative pain may induce various immobility-related complications, muscle weakness, and chronic pain. Therefore, post-TKA analgesia is crucial, not only for patients’ satisfaction, but for improving surgical outcomes and reducing complications. The present study aims to compare the effect of ultrasound-guided adductor canal block ACB (saphenous nerve block) versus incremental dose of intravenous morphine after total knee arthroplasty surgery. Results The results of this study revealed no difference between group A and group B as regards postoperative quadriceps muscle strength; maximal knee flexion, total distance ambulated, and postoperative vital data (heart rate per minute and respiratory rate per minute). However, group A showed better postoperative pain control, lower doses of intravenous morphine consumption and lower incidence of nausea and vomiting. Conclusion Continuous adductor canal block (saphenous nerve block) is superior to intravenous morphine in decreasing postoperative pain and decreasing total morphine consumption and adverse effects as nausea and vomiting, but both are equivalent in preserving quadriceps muscle power.

scholarly journals Robotic Arm-Assisted Total Knee Arthroplasty in the Setting of Combined Extra-articular Deformities of the Femur and Tibia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sharma Cook-Richardson ◽  
Rasesh Desai
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Treatment ◽  
Treatment Option ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Robotic Arm ◽  
Implant Positioning ◽  
Total Knee ◽  
Anatomical Axis ◽  
Bone Deformities

In this case, we will describe a 68-year-old man with combined femoral and tibial bone deformities who underwent robotic arm-assisted total knee arthroplasty (RATKA) to treat his severe osteoarthritis in the setting of extra-articular deformities that altered the native anatomical axis and the kinematics of the deformed extra-articular bony structures which chronically generated a neomechanical axis. The combination of severe osteoarthritis with extra-articular deformities made the RATKA method the best surgical treatment option taking into account altered kinematics of the native joint which conventional jig-based total knee arthroplasty would not have prioritized during bony cuts and implant positioning. The patient underwent successful knee arthroplasty with robotic arm-assisted technology with restoration of the mechanical axis.

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