• Paula J Yu, Eldon Loh, Anne M R Agur, and John Tran.
• Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
• Pain Med. 2024 Oct 17.

BackgroundRadiofrequency ablation is a common non-opioid treatment to manage chronic knee pain. The inferior medial genicular nerve is conventionally targeted. It has been suggested that the infrapatellar branch(saphenous nerve) should also be targeted. There is controversy regarding the contribution of the infrapatellar branch to the innervation of the knee joint capsule.Objective1) Identify the frequency of the branching pattern(s) of the infrapatellar branch in 3D; 2) Assess spatial relationships of branches of infrapatellar branch to the inferior medial genicular nerve; 3) Determine if capturing infrapatellar branch could result in additional benefit to the existing protocol.DesignAnatomical Study.MethodsThe infrapatellar branch and inferior medial genicular nerve were serially dissected, digitized, and modelled in 3D in 7 specimens(mean age 57.8 ± 2.0; 2F/5M) and their relationship documented. The spatial relationship of the nerves was used to assess the anatomical efficacy of including the infrapatellar branch in the protocol.ResultsThe infrapatellar branch is most frequently a cutaneous nerve. This nerve was variable and found to be unbranched or have 2-3 branches and in all specimens was located superficial to the branches of inferior medial genicular nerve. When the infrapatellar branch (1) coursed more distally, the strip lesion would not capture the infrapatellar branch but would capture inferior medial genicular nerve consistently;(2) overlapped with the inferior medial genicular nerve, the strip lesion would capture both nerves.ConclusionsProposed protocol targeting the infrapatellar branch is likely to capture the inferior medial genicular consistently regardless of the anatomical variation of the infrapatellar branch.© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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