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Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation
Journal article   Peer reviewed

Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation

Carlo D Franco, Asokumar Buvanendran, Jeffrey D Petersohn, Robert D Menzies and Linda Pham Menzies
Regional anesthesia and pain medicine, v 40(4), pp 363-368
Jul 2015
PMID: 26066383

Abstract

Anatomic Landmarks Catheter Ablation - adverse effects Catheter Ablation - methods Dissection Humans Joint Capsule - diagnostic imaging Joint Capsule - innervation Joint Capsule - surgery Knee Joint - diagnostic imaging Knee Joint - innervation Knee Joint - surgery Peripheral Nerve Injuries - etiology Peripheral Nerve Injuries - prevention & control Radiography
Chronic knee pain is common in all age groups. Some patients who fail conservative therapy benefit from radiofrequency neurotomy. Knowledge of the anatomy is critical to ensure a successful outcome. The purpose of this study was to reanalyze the innervation to the anterior knee capsule from the perspective of the interventional pain practitioner. The study included a comprehensive literature review followed by dissection of 8 human knees to identify the primary capsular innervation of the anterior knee joint. Photographs and measurements were obtained for each relevant nerve branch. Stainless-steel wires were placed along the course of each primary innervation, and radiographs were obtained. Literature review revealed a lack of consensus on the number and origin of nerve branches innervating the anterior knee capsule. All dissections revealed the following 6 nerves: superolateral branch from the vastus lateralis, superomedial branch from the vastus medialis, middle branch from the vastus intermedius, inferolateral (recurrent) branch from the common peroneal nerve, inferomedial branch from the saphenous nerve, and a lateral articular nerve branch from the common peroneal nerve. Nerve branches showed variable proximal trajectories but constant distal points of contact with femur and tibia. The inferolateral peroneal nerve branch was found to be too close to the common peroneal nerve, making it inappropriate for radiofrequency neurotomy. The innervation of the anterior capsule of the knee joint seems to follow a constant pattern making at least 3 of these nerves accessible to percutaneous ablation. To optimize clinical outcome, well-aligned radiographs are critical to guide lesion placement.

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Collaboration types
Domestic collaboration
Web of Science research areas
Anesthesiology
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