Table 1.
Saphenous nerve injury after knee surgery
| Reference | Surgical procedure | Incision | Outcome measure | Time postoperative | Result | Study type |
|---|---|---|---|---|---|---|
| Heare et al., 2015 | Intramedullary nailing of an open tibial shaft fracture | 4 cm oblique scar at the junction between middle and distal anteromedial tibia, at the original open fracture site | Pain scores before and after selective anesthetic injection | 1 year | Selective neurolysis and partial neurectomy, w/complete resolution of neuralgia and pain | Case report |
| Figueora et al., 2015 | Arthroscopic ACL (hamstrings) | Longitudinal, <25 mm, 50 mm from the medial articular margin, medial to the tibial tuberosity | Neurology consult 3 weeks after surgery, w/light touch and pinprick sensation exam and electrophysiology | 3 weeks | Area of hypoesthesia in the IPSN territory in 17/22 knees; injury to IPSN el/cally detected in 15 patients; saphenous n. injury also in 2 patients | Case series (prospective) |
| Jameson and Emmerson, 2007 | Arthroscopic ACL (hamstrings) | Longitudinal, 30 mm, over the pes anserinus | Questionnaire sent by post | 13-78 months | LSCN: 29 patients (33%) | Case series (retrospective) |
| SN: 23 patients (26%) | ||||||
| IPSN: 10 patients (12%) | ||||||
| Liden et al., 2007 | Arthroscopic ACL (donor site issues in BTB vs. ST autograft) | BTB: 2 vertical 25 mm incisions; ST: 3 cm oblique over the pes anserinus | Clinical exam; pain assessment | 7 years | Anterior knee pain in 39% of BTB group and 26% of ST group | RCT |
| Sanders et al., 2007 | Arthroscopic ACL (hamstrings) | 2 cm longitudinal over pes anserinus | Patients questionnaire | Variable | SBSN: 14/62 or 23% | Case series (retrospective), followed by cadaveric study to identify anatomic relations |
| IPSN: 12/62 or 19% | ||||||
| Combined: 20/62 or 32% | ||||||
| Papastergiou et al., 2006 | Arthroscopic ACL (hamstrings) | 3 cm vertical versus 3 cm horizontal incision for graft harvesting | Sensory exam for IPSN sensory changes | 1-12 months | Vertical group: sensory changes in 46/116 patients or 39.7% | Case series (retrospective) |
| Horizontal group: sensory changes in 17/114 patients or 14.9% | ||||||
| Portland et al., 2005 | Arthroscopic ACL (BTB) | Vertical versus horizontal incision for graft harvesting | Medical records review; patient questionnaire | At least 3 years | IPSN damage evidence in 20/34 patients or 59% in the vertical group; 18/42 patients or 43% in the horizontal group | Case series (retrospective) |
| Mochizuki et al., 2004 | Arthroscopic ACL (hamstrings) | Vertical incision | Patient questionnaire sent by post | 32 months | 47/86 (55%) reported sensory changes | Case series (retrospective) |
| Sgaglione et al., 1990 | Open ACL (hamstrings) | Medial parapatellar incision | Personal interview | 24-81 months | IPSN numbness in 27/72 patients (38%); significantly bothersome in 1/72 patients (1.4%) | Case series (retrospective) |
| Bertram et al., 2000 | Arthroscopic ACL (hamstrings) | Vertical incision over the pes anserinus | Sensory exam | Immediately | SN neurolysis w/immediate resolution of symptoms | Case report |
| Kachar et al., 2008 | Total knee arthroplasty | Midline skin incision | 11-point Numerical Rating Scale | 21 months | SN neurolysis and neuroma resection w/resolution of symptoms | Case report |
| Leliveld et al., 2012 | Intramedullary nailing of the tibia | 46 medial parapatellar; 26 transtendinous | SF-36; AKPS; study-specific questionnaire | Variable | IPSN deficit in 43/72 (60%); 12 nails removed due to knee pain; pain persisted in 7/12 patients | Case series (retrospective) |
SN=Saphenous nerve, ACL=Anterior cruciate ligament, IPSN=Infrapatellar branch of the saphenous nerve, LSCN=Lateral sural cutaneous nerve, SBSN=Suprapatellar branch of the saphenous nerve, BTB=Bone-patellar tendon-bone graft, ST=Semitendinosus graft, SF-36=Short form-36, AKPS=Anterior knee pain scale, RCT=Randomized controlled trial