Selective denervation of infrapatellar branch of saphenous nerve effectively improves QoL of TKA patients having pain

The results showed a statistically significant improvement (p < 0.05) of patients pain perception (mean NRS improvement –4.2, SD 2.5) and overall satisfaction (with a mean increase in OKS of 14.5 points SD 9.4, and in SF12 of 6.5 points SD 4.0).

In particular, the greatest improvement was observed on the SF12 Physical subscale, increased from 9 (±1.3) to 13.1 (±2.3) (p = 0.0019).

The authors concluded that – “The IPBSN is at risk for iatrogenic damage in any surgery on the anteromedial aspect of the knee, especially when longitudinal incisions are used. The neuroma that could result from this damage is an under-estimated source of persistent anterior pain. Our suggestion is to consider neuroma of the IPBSN as a differential diagnosis in order to avoid an unnecessary revision surgery. Despite its limitations, our study suggests that selective neuroma denervation provides a better outcome than local injective treatments and often results as a complete pain resolution. Multicentric studies, with bigger samples, should further investigate the data collected regarding the real incidence of the disease, its correct diagnosis and its impact on the quality of life of patients.”

Further reading:

Painful total knee arthroplasty: Infrapatellar branch of the saphenous nerve selective denervation. A case series

Alessio Giannetti, Luigi Valentino et al

The Knee 39 (2022) 197–202

https://doi.org/10.1016/j.knee.2022.09.010