The Anatomical Distribution Of The Infrapatellar Branch Of The Saphenous Nerve And The Effect Of Denervation On Anterior Knee Pain After Knee Replacement

Objective To study the anatomical distribution of the infrapatellar branch of the saphenous nerve .Retrospectively analyze the effect of total knee replacement (TKR) or unicompartmental knee replacement (UKR) with denervation of the infrapatellar branch of saphenous nerve on anterior knee pain so as to provide references for the clinical treatment. Methods From 1 January to 1 March 2006, 56 patients and 63 knees (45 TKR and 7 UKR) were followed up. Among these patients, 47 patients and 52 knees (45 TKR and 7 UKR) were included in this study. All knees had been replacemented among April 2001 to October 2005. All patients had been diagnosised as osteoarthritis before operation. We followed up these patients 4-58 months after operation, the average following up time was 20.9 months. These knees been devided into two groups by whether the infrapatellar branch of the saphenous nerve was excisioned . A grouprwe chose the median parapatellar approach and did not excision the infrapatellar branch of the saphenous nerve . B group: we chose the vastus medialis muscle splitting approach and excisioned the infrapatellar branch of the saphenous nerve .The score of HSS was measured by the Hospital for Special Surgery s Score System, and the severity of anterior knee pain was measured with patient visual pain index. The statistical analysis was carried out using SPSS 12.0 for Windows, Date were analyzed using t test.The infrapatellar branch of the saphenous nerve of 14 knees of cadavers were observed and measured.Results There were 27 patients 30 knees (30 TKR) in group A. The HSS score was 49.1±4.4 before operation and 90.8±2.7 after operation. The pain score was 7.13±0.73 and 1.83±0.75 respectively before and after operation. There were 20 patients 22 knees...