The influence of the variety of the infrapatellar branch of the saphenous nerve on the risk of iatrogenic injuries during arthroscopic procedures in the knee joint

Abstract

Introduction: The saphenous nerve is a clinically important nerve that may differ in its anatomical course among individuals and between the left and right limbs of a person. The infrapatellar branch of the saphenous nerve (IPBSN) is purely sensory. It arises from the saphenous nerve in the adductor hiatus before piercing the fascia lata. Then it becomes subcutaneous and innervates the anteromedial portion of the knee. The injury can be caused by trauma, such as a fall on the knee or a direct blow to the knee joint, as well as by surgical procedures, such as arthroscopy, total knee replacement, hamstring tendon harvest for anterior cruciate ligament (ACL) procedures. The aim of this study was to provide a comprehensive overview of the clinically relevant anatomy of the IPBSN and its influence on the risk of iatrogenic injuries during arthroscopic procedures. Methods: A narrative review of the current literature was conducted using databases including PubMed, Embase, Ovid, and Cochrane. Information was gathered regarding the prevelance of iatrogenic injuries of IPBSN during knee arthroscopy. This review focuses on the most popular arthroscopic procedures such as ACL reconstruction and meniscal repair. Conclusion: Although all of the nerves can be damaged during these procedures, the infrapatellar branch of the saphenous is the most common iatrogenic injury of the nerve. Due to the wide variety of the course of the IPBSN, it is difficult to avoid these injuries during reconstructive knee surgery.

Keywords

• Hamstring tendon harvest
• Iatrogenic
• Infrapatellar branch of saphenous nerve
• ACL reconstruction