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Figure 8: Resection of the Infrapatellar Branch of the Saphenous Nerve. A) Woman 9 years after total knee arthroplasty whose knee is shown from medial aspect demonstrating sites of pain over the anterior femoral cutaneous nerve (proximally), over the medial cutaneous nerve of the thigh (and medial retinacular nerve), and over the infrapatellar branch of the saphenous nerve. B) The infrapatellar branch is noted overlying Gurdy’s tubercle. C) The nerve is infiltrated with local anesthetic prior and then D) cauterized and divided. E) The proximal end of the nerve is dissected and implanted into an adductor muscle medially (location denoted by finger at the popliteal fossa. F) A search must be made proximally for other infrapatellar branches. One is shown here in the incision used to resect the medial cutaneous nerve of the thigh and the medial retinacular nerves. |