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Anatomical risk evaluation of iatrogenic injury to the infrapatellar branch of the saphenous nerve during medial meniscus arthroscopic surgery

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Abstract

Purpose

To determine the relationship of the medial meniscus with the infrapatellar branches of the saphenous nerve, the primary goal is to define and characterize different risk areas for these nerves during medial meniscus surgery.

Methods

After dissecting 20 embalmed cadaver knees, we defined 7 readily identifiable anatomical landmarks. For each knee, we recorded 2 morphological criteria and 16 measurements.

Results

The most common anatomical course is a main trunk that is 8 mm anterior to the tuberculum adductorium and 60 mm posterior to the midpoint of the medial patellar margin. It has two main infrapatellar branches. The nerve division is 23 mm above the joint line. The path is oblique with an angle of 55.5°. The anterior meniscal landmark is 24 mm from the upper branch and 42.5 mm from the lower branch. The posterior meniscal landmark is 55 mm from the upper branch and 38 mm from the lower branch.

Conclusions

We defined a common anatomical course for the saphenous nerve and its infrapatellar branches. Then, three different areas were defined at risk for iatrogenic nerve injuries during medial meniscus.

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Authors and Affiliations

  1. Department of Anatomy, University of Strasbourg, 4 rue kirschleger, 67000, Strasbourg, France

    Guillaume Koch, Jean-Luc Kahn & Philippe Clavert

  2. Department of Interventional Radiology, Strasbourg University Hospital, 1 place de l’hôpital, 67000, Strasbourg, France

    Guillaume Koch, Roberto Luigi Cazzato & Julien Garnon

  3. Department of Orthopedic Surgery-CCOM, Strasbourg University Hospital, 10 avenue Baumann, 67403, Illkirch, France

    Agathe Kling & Philippe Clavert

  4. Department of Radiology, Central Manchester University Hospitals, Manchester, UK

    Nitin Ramamurthy

  5. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Faramarz Edalat

Authors
  1. Guillaume Koch
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  2. Agathe Kling
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  3. Nitin Ramamurthy
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Correspondence to Guillaume Koch.

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Koch, G., Kling, A., Ramamurthy, N. et al. Anatomical risk evaluation of iatrogenic injury to the infrapatellar branch of the saphenous nerve during medial meniscus arthroscopic surgery. Surg Radiol Anat 39, 611–618 (2017). https://doi.org/10.1007/s00276-016-1781-z

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  • DOI: https://doi.org/10.1007/s00276-016-1781-z

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