Cryoablation of the Infrapatellar Branch of the Saphenous Nerve Identified by Non-Invasive Peripheral Nerve Stimulator for the Treatment of Non-Surgical Anterior Knee Pain: A Case Series and Review of the Literature

Aim: This case series looks at outcomes in 39 patients implanted using the Bioness Stimrouter system on various isolated mononeuropathies. Patients & methods: A case series of 39 patients with a total of 42 implants were enrolled starting August 2017 at various pain management centers. Results: Of 39 patients studied, 78% of the participants noticed an improvement in their pain. There was a 71% reduction in pain scores with the average preprocedure score of 8 improving to 2 post-implant. Participants noted on average a 72% improvement in activity with the greatest observed in the brachial plexus (80%) and suprascapular nerve (80%) and smallest in the intercostal nerve (40%). Approximately 89% of those implanted with a peripheral nerve stimulator experienced a greater than 50% reduction in opioid consumption. Conclusion: Peripheral nerve stimulators are a new, minimally invasive neuromodulation modality that shows promising early results in our 39-patient case series.

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Injury to the infrapatellar branch of the saphenous nerve, a possible cause for anterior knee pain after tibial nailing?

Injury ◽

10.1016/j.injury.2011.09.002 ◽

2012 ◽

Vol 43 (6) ◽

pp. 779-783 ◽

Cited By ~ 41

Author(s):

M.S. Leliveld ◽

M.H.J. Verhofstad

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Saphenous Nerve ◽

Infrapatellar Branch ◽

Anterior Knee ◽

Possible Cause

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Chronic Anterior Knee Pain in a Wrestling Athlete from a Neuroma of the Infrapatellar Branch of the Saphenous Nerve

Kansas Journal of Medicine ◽

10.17161/kjm.v13i1.13625 ◽

2020 ◽

Vol 13 (1) ◽

pp. 79-80

Author(s):

Jean-Philippe Darche ◽

Lisa Vopat ◽

David Smith ◽

Albert Zheng ◽

Bryan Vopat

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Saphenous Nerve ◽

Infrapatellar Branch ◽

Anterior Knee

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Electroencephalographic changes associated with non-invasive nociceptive stimulus in minimally anaesthetised dogs

Polish Journal of Veterinary Sciences ◽

10.1515/pjvs-2016-0086 ◽

2016 ◽

Vol 19 (4) ◽

pp. 675-683 ◽

Cited By ~ 1

Author(s):

U. Kaka ◽

Y.M. Goh ◽

L.W. Chean ◽

H.C. Chen

Keyword(s):

Peripheral Nerve ◽

Analgesic Effect ◽

Median Frequency ◽

Nerve Stimulator ◽

Peripheral Nerve Stimulator ◽

Electric Stimulus ◽

Non Invasive ◽

Nociceptive Stimulus ◽

Before And After ◽

Electrical Stimuli

Abstract Electroencephalography (EEG) has been reported as an objective, non-invasive and stress free technique for nociceptive studies. Electrical stimuli can be used to evaluate the efficacy of centrally acting agents. Peripheral nerve stimulator can be a good and cheap source of electric stimulus for studies of nociception, and studies evaluating analgesic effect of drugs under EEG. In this study suitability of peripheral nerve stimulator, and milliamperage for nociceptive studies under electroencephalography were evaluated. Six dogs were subjected to electric stimulus of 20, 40, 60 and 80 milliamperes (mAs) before and after tramadol administration at 4 mg/kg IV. Electroencephalograph was recorded during electric stimulus prior tramadol (pre-tramadol) and during electric stimulus after tramadol (post-tramadol) under minimal anaesthesia. Anaesthesia was induced with propofol and maintained with halothane at a stable concentration between 0.85 and 0.95%. Pre-tramadol median frequency (MF) increased significantly (p<0.05) at 40, 60 and 80 mAs post-electric stimulus compared to baseline MF. No difference in pre-tramadol MF was observed between 60 and 80 mAs. Tramadol produced significant effect by depression of MF at all intensities. The effect was less evident at 80 mAs. The results revealed that tramadol produced evident effect between 20 and 60 mAs. Thus, it is concluded that nerve stimulator can be used with the current between 20 and 60 mAs for nociceptive studies.

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Injury to the infrapatellar branch of the saphenous nerve, a possible cause for anterior knee pain after tibial nailing?

Yearbook of Orthopedics ◽

10.1016/j.yort.2012.05.056 ◽

2012 ◽

Vol 2012 ◽

pp. 104-106

Author(s):

M.F. Swiontkowski

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Saphenous Nerve ◽

Infrapatellar Branch ◽

Anterior Knee ◽

Possible Cause

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Nonoperative treatment of recalcitrant neuritis of the infrapatellar saphenous nerve: a case series

Journal of Medical Case Reports ◽

10.1186/s13256-021-02912-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Beth Pearce

Keyword(s):

Neuropathic Pain ◽

Umbilical Cord ◽

Case Series ◽

Nonoperative Treatment ◽

Saphenous Nerve ◽

Case Presentation ◽

Paindetect Questionnaire ◽

Infrapatellar Branch ◽

Total Knee ◽

Anterior Knee

Abstract Background Neuritis of the infrapatellar branch of the saphenous nerve can result from iatrogenic injury, entrapment, bursitis, or patellar dislocation. Currently, there is an unmet clinical need for treating refractory neuritis nonsurgically. Case presentation Three patients presented with persistent anterior knee pain caused by neuritis of the infrapatellar branch of the saphenous nerve that had got excellent but only temporary relief from steroid and local anesthetic nerve block. The neuropathic pain diagnostic Douleur Neuropathique 4 questionnaire and painDETECT questionnaire confirmed presence of neuropathic pain. After injection with 25 mg amniotic and umbilical cord particulate, the patient’s pain decreased from 7.3 before injection to 0.3 at 6 weeks postinjection. In addition, neuropathic symptoms significantly improved at 2 weeks and were not present by 6 weeks. By 63 weeks, two of the patients reported continued complete pain relief, while one patient underwent total knee replacement due to an allergy of a previously implanted unicondylar implant. Conclusions This case series suggests that amniotic and umbilical cord particulate may be a viable alternative to reduce pain in patients with neuropathic pain.

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