A small portion of patients suffer from severe knee pain following previous knee surgery or a trauma. Awareness among traumatologists regarding a neuropathic origin of this persistent knee pain is poor. Ongoing pain close to the knee may be caused by damage of the infrapatellar nerve (IN). This branch of the saphenous nerve is purely sensory and is at risk for iatrogenic damage due to its superficial medial course. Once recognized using simple tests during physical examination, a variety of treatment modalities may be proposed. However, a standard treatment algorithm was hitherto absent. This study includes 15 patients having IN damage who were offered a step-up regimen including lidocaine injections, pulsed radiofrequency (PRF) or neurectomy. Success (>50% drop in numeric rating scale pain score) was attained in 11 (73% success rate, 9 month median follow-up). The aim of this contribution is to increase knowledge regarding this illusive entity and to discuss the efficacy of our treatment protocol.
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http://dx.doi.org/10.1007/s00113-019-0688-7 | DOI Listing |
Pain Med
January 2025
Department of Physical Medicine and Rehabilitation, Western University, London, Ontario N6C 0A7, Canada.
Background: Radiofrequency ablation is a common non-opioid treatment to manage chronic knee pain. The inferior medial genicular nerve is conventionally targeted. It has been suggested that the infrapatellar branch (saphenous nerve) should also be targeted.
View Article and Find Full Text PDFActa Ortop Bras
October 2024
Pontificia Universidade Paulista, Faculdade de Ciencias Medicas, Nucleo de Ortopedia e Traumatologia Esportiva, Sao Paulo, SP, Brazil.
Cureus
August 2024
Department of Neurological Surgery, Nippon Medical School, Tokyo, JPN.
Lower back and lower limb pain can hamper the rehabilitation of cerebral stroke patients. We report that peripheral nerve blocks enabled two patients to continue rehabilitation. Case 1 was an 83-year-old female with left hemiparesis due to cerebral infarction of the right basal ganglia.
View Article and Find Full Text PDFCureus
August 2024
Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA.
Osteoarthritis, the most common joint disease of adults worldwide, is increasing in prevalence due to an increase in aging and rates of obesity in developed countries. Treatment options include physical therapy, pharmacologic management, non-pharmacologic management, and total knee replacement surgery. When conservative measures fail, total knee replacement surgery is pursued.
View Article and Find Full Text PDFCureus
June 2024
Department of Orthopedics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, IND.
Ancient schwannoma, a rare subtype of schwannoma, a benign tumor originating from nerve sheaths, can arise from various nerves, except for the optic, olfactory, spinal, and autonomic nervous systems. Schwannomas are typically characterized by the presence of neoplastic Schwann cells and tend to develop eccentrically. Malignant transformations of schwannomas are exceptionally uncommon.
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