Infrapatellar nerve damage : Aneglected cause of severe localized leg pain.

Abstract

Asmall portion of patients suffer from severe knee pain following previous knee surgery or atrauma. Awareness among traumatologists regarding aneuropathic origin of this persistent knee pain is poor. Ongoing pain close to the knee may be caused by damage of the infrapatellar nerve (IN). This branch of the saphenous nerve is purely sensory and is at risk for iatrogenic damage due to its superficial medial course. Once recognized using simple tests during physical examination, avariety of treatment modalities may be proposed. However, astandard treatment algorithm was hitherto absent. This study includes 15patients having IN damage who were offered astep-up regimen including lidocaine injections, pulsed radiofrequency (PRF) or neurectomy. Success (>50% drop in numeric rating scale pain score) was attained in 11 (73% success rate, 9month median follow-up). The aim of this contribution is to increase knowledge regarding this illusive entity and to discuss the efficacy of our treatment protocol.