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Neuropathische Schmerzen nach Läsion des R. infrapatellaris des N. femoralis

Wichtige Differenzialdiagnose chronischer Knieschmerzen

Neuropathic pain following lesions of the infrapatellar branch of the femoral nerve

An important differential diagnosis in anterior knee pain

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Zusammenfassung

Es werden 2 Kasuistiken einer Läsion des R. infrapatellaris des N. femoralis nach Knie-TEP-Operation berichtet. Bei einer Patientin entwickelte sich ein komplexes regionales Schmerzsyndrom (CPRS II, Kausalgie). Die Symptomatik besteht aus häufig belastungsabhängigen schneidenden und brennenden Schmerzen sowie Sensibilitätsstörungen (Hypästhesie, Allodynie) im Versorgungsgebiet des Nerven. Dieser läuft als Ast des N. femoralis medial der Fascia lata an der Innenseite des Knies zur Tuberositas tibiae, wobei mehrere anatomische Verlaufsvarianten beschrieben sind. Anhand einer Literaturrecherche werden Klinik, Anatomie, Differenzialdiagnose sowie therapeutische Konsequenzen besprochen.

Abstract

We report on two patients with neuropathic knee pain following lesions of the infrapatellar branch of the femoral nerve due to knee joint replacement. In one patient, the neuropathic pain syndrome was complicated by the development of complex regional pain syndrome (CPRS II, causalgia). Patients exhibit a sharp, burning pain, often induced by exercise, and sensory impairment in the skin area supplied by the infrapatellar nerve. This nerve is a branch of the femoral nerve medial to the fascia lata and is responsible for the skin sensation of the anterior and medial part of the knee. Clinical features, anatomy, diagnostic methods and therapeutic options are reviewed.

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Literatur

  1. Von Sirang H (1972) Ursprung, Verlauf und Äste des N. saphenus. Anat Anz 130:158–159

    Google Scholar 

  2. Purner J (1971) Über den peripheren Verlauf des N. saphenus. Anat Anz 129:114–132

    PubMed  CAS  Google Scholar 

  3. Tennent TD, Birch NC, Holmes MJ et al (1998) Knee pain and the infrapatellar branch of the saphenous nerve. J R Soc Med 91:573–575

    PubMed  CAS  Google Scholar 

  4. Mochida H, Kikuchi S (1995) Injury to infrapatellar branch of saphenous nerve in arthroscopic knee surgery. Clin Orthop 320:88–94

    PubMed  Google Scholar 

  5. Ganzoni N, Wieland K (1978) Zur Bedeutung des Ramus infrapatellaris des N. saphenus bei der medialen Arthrotomie des Kniegelenkes. Z Unfallmed Berufskr 71:120–125

    PubMed  CAS  Google Scholar 

  6. Kataoka Y, Arai M, Kanno H (1990) Reflex sympathetic dystrophy of the knee after arthroscopic surgery: report of 3 cases. Orthop Surg 41:1407–1411

    Google Scholar 

  7. Poeling GG, Pollock FE, Koman LA (1988) Reflex sympathetic dystrophy of the knee after sensory nerve injury. J Arthrosc Rel Surg 4:31–35

    Article  Google Scholar 

  8. Nahabedian MY, Johnson CA (2001) Operative management of neuromatous knee pain: patient selection and outcome. Ann Plast Surg 46:15–22

    Article  PubMed  CAS  Google Scholar 

  9. Tranier S, Durey A, Chevallier B, Liot F (1992) Value of somatosensory evoked potentials in saphenouis entrapment neuropathy. J Neurol Neurosurg Psychiatr 55:461–465

    Article  PubMed  CAS  Google Scholar 

  10. House JH, Ahmed K (1977) Entrapment neuropathy of the infrapatellar branch of the saphenous nerve – A new peripheral nerve entrapment syndrome? Am J Sports Med 5:217–224

    Article  PubMed  CAS  Google Scholar 

  11. Gordon GC (1952) Traumatic prepatellar neuralgia. J Bone Joint Surg 34B:41–44

    Google Scholar 

  12. Ikpeme JO, Gray C (1995) Traumatic prepatellar neuralgia. Injury 26:225–229

    Article  PubMed  CAS  Google Scholar 

  13. Detenbeck LC (1972) Infrapatellar traumatic neuroma resulting from dashboard injury. J Bone Joint Surg 54A:170–172

    Google Scholar 

  14. Swanson AGJ (1983) Prepatellar neuropathy following medial meniscotomy. Clin Orthop 181:151–153

    PubMed  Google Scholar 

  15. Huckell JR (1965) Meniscotomy: A benign procedure? A long term follow-up study. Can J Surg 8:254–257

    Google Scholar 

  16. Baron R, Jänig W (2001) Neuropathische Schmerzen. In: Zenz M, Jurna I (Hrsg) Lehrbuch der Schmerztherapie. Wissenschafliche Verlagsgesellschaft, Stuttgart, S 65–87

  17. Sherman OR, Fox JM, Snyder SJ (1986) Arthroscopy – no problem surgery? J Bone Joint Surg 68A:256–264

    Google Scholar 

  18. Ellen MI, Jackson HB, DiBiase SJ (1999) Uncommon causes of anterior knee pain. Am J Phys Med Rehabil 78:376–380

    Article  PubMed  CAS  Google Scholar 

  19. Romanoff ME, Cory PC, Kalenak A et al (1989) Saphenous nerve entrapment in the adductor canal. Am J Sports Med 17:478–481

    Article  PubMed  CAS  Google Scholar 

  20. Dellon Al, Mont MA, Mullick T, Hungerford DS (1996) Partial denervation for neuromatous knee pain around the knee. Clin Orthop Rel Res 329:216–222

    Article  Google Scholar 

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Authors and Affiliations

  1. Abteilung für Neurologie und Schmerztherapie, Rommel-Klinik GMBH, Bätznerstr. 94–96, 75323, Bad Wildbad, Deutschland

    O. Rommel, L. Finger & A. Eichbaum

  2. Abteilung für Orthopädie, Rommel-Klinik GMBH, Bad Wildbad, Deutschland

    E. Bös & G. Jäger

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  1. O. Rommel
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  2. L. Finger
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  3. E. Bös
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  4. A. Eichbaum
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  5. G. Jäger
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Correspondence to O. Rommel.

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Rommel, O., Finger, L., Bös, E. et al. Neuropathische Schmerzen nach Läsion des R. infrapatellaris des N. femoralis. Schmerz 23, 355–359 (2009). https://doi.org/10.1007/s00482-009-0787-4

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  • DOI: https://doi.org/10.1007/s00482-009-0787-4

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