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

• Published in: Surgical and radiologic anatomy (English ed.) Vol. 39; no. 6; pp. 611 - 618
• Main Authors: Koch, Guillaume, Kling, Agathe, Ramamurthy, Nitin, Edalat, Faramarz, Cazzato, Roberto Luigi, Kahn, Jean-Luc, Garnon, Julien, Clavert, Philippe
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.06.2017; Springer Nature B.V; Springer Verlag (Germany)
• Subjects: Anatomic Landmarks; Anatomy; Anatomy & physiology; Arthroscopy; Arthroscopy - adverse effects; Cadaver; Femoral Nerve - anatomy & histology; Femoral Nerve - injuries; Human health and pathology; Humans; Iatrogenesis; Iatrogenic Disease; Imaging; Knee; Knee Joint - innervation; Knee Joint - surgery; Life Sciences; Medicine; Medicine & Public Health; Menisci, Tibial - surgery; Meniscus; Nerves; Original Article; Orthopedics; Radiology; Saphenous nerve; Surgery; Knee; Infrapatellar branches; Arthroscopy; Medial meniscus; Saphenous nerve
• ISSN: 0930-1038; 1279-8517
• DOI: 10.1007/s00276-016-1781-z

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.