TY - JOUR
T1 - An anatomical neurovascular study for procedures targeting peri-articular nerves in patients with anterior knee pain
AU - Park, Mi Ran
AU - Kim, Dasom
AU - Rhyu, Im Joo
AU - Yu, Joon Ho
AU - Hong, Jisu
AU - Yoon, Siyeop
AU - Lee, Deukhee
AU - Koh, Jae Chul
N1 - Funding Information:
The program used to measure the distance between conventional target points and nerves was developed in work supported by the Ministry of Trade Industry & Energy (MOTIE, Korea), Ministry of Science & ICT (MSIT, Korea), and Ministry of Health & Welfare (MOHW, Korea) under the Technology Development Program for AI-Bio-Robot-Medicine Convergence (20001655).
Publisher Copyright:
© 2020 The Authors
PY - 2020/10
Y1 - 2020/10
N2 - Background: Radiofrequency ablation (RFA) of the articular branches innervating the anterior knee capsule has been studied as a possible alternative to surgery for degenerative arthritis. However, the neurovascular topography of the anterior knee capsule remains unclear. Methods: One leg from each of the 20 formalin-embalmed cadaveric specimens was investigated. Modified ablation points (MAPs) were evaluated for a possible alternative for conventional target points (CAPs). Results: For the nerve to vastus medialis (NVM), the probability of identifying the nerve was higher at MAP compared with CAP (62.5% vs. 25%). The mean shortest distance from the nerve was shorter at MAP compared with CAP (18.0 mm vs. 29.9 mm). The probabilities and distances for other nerves were not significantly different between the points. However, the probability of identifying the artery was significantly lower at MAPs compared with CAPs for arteries (0%, 5.3%, and 0% vs. 84.2%, 84.2%, and 73.3% for superior medial genicular, superior lateral genicular, and inferior medial genicular artery, respectively). For the recurrent peroneal nerve (RPN), a new target point was set in MAPs. Conclusions: The current landmark for genicular nerve procedures may not accurately target the correct nerve position, or reduce the risk for vessel damage. A more proximal target may reduce complications and increase the probability of successful procedures, although clinical correlation is needed.
AB - Background: Radiofrequency ablation (RFA) of the articular branches innervating the anterior knee capsule has been studied as a possible alternative to surgery for degenerative arthritis. However, the neurovascular topography of the anterior knee capsule remains unclear. Methods: One leg from each of the 20 formalin-embalmed cadaveric specimens was investigated. Modified ablation points (MAPs) were evaluated for a possible alternative for conventional target points (CAPs). Results: For the nerve to vastus medialis (NVM), the probability of identifying the nerve was higher at MAP compared with CAP (62.5% vs. 25%). The mean shortest distance from the nerve was shorter at MAP compared with CAP (18.0 mm vs. 29.9 mm). The probabilities and distances for other nerves were not significantly different between the points. However, the probability of identifying the artery was significantly lower at MAPs compared with CAPs for arteries (0%, 5.3%, and 0% vs. 84.2%, 84.2%, and 73.3% for superior medial genicular, superior lateral genicular, and inferior medial genicular artery, respectively). For the recurrent peroneal nerve (RPN), a new target point was set in MAPs. Conclusions: The current landmark for genicular nerve procedures may not accurately target the correct nerve position, or reduce the risk for vessel damage. A more proximal target may reduce complications and increase the probability of successful procedures, although clinical correlation is needed.
KW - Interventional pain management
KW - Lower extremity
KW - Neuroanatomy
KW - Osteoarthritis
KW - Radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=85090017104&partnerID=8YFLogxK
U2 - 10.1016/j.knee.2020.08.006
DO - 10.1016/j.knee.2020.08.006
M3 - Article
C2 - 33010776
AN - SCOPUS:85090017104
SN - 0968-0160
VL - 27
SP - 1577
EP - 1584
JO - Knee
JF - Knee
IS - 5
ER -