Saphenous nerve pain after knee surgery

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  2. Persistent anterior knee pain, especially after surgery, can be very frustrating for the patient and the clinician. Injury to the infrapatellar branch of the saphenous nerve (IPS) is not uncommon after knee surgeries and trauma, yet the diagnosis and treatment of IPS neuralgia is not usually taught in pain training programs. I
  3. Saphenous neuritis is a painful condition caused by either irritation or compression at the adductor canal or elsewhere along the course of the saphenous nerve. The condition also may be associated with surgical or nonsurgical trauma to the nerve, especially at the medial or anterior aspect of the knee
  4. through the subsartorial fascia that the nerve is quite superficial and most mechanically vulnerable.16 The saphenous nerve may be injured at this location through arthroscopic surgery,1,3-6,12,20,22,23,28,29,32 arterial bypass or venous stripping surgery,5,7,11,21,23,25,27,30 as well as throug

Background Injury to the infrapatellar branch of the saphenous nerve (IBSN) is common during total knee arthroplasty (TKA) with a standard midline skin incision. Occasionally, painful neuromas form at the transection of nerve and cause pain and limitation of the range of motion of the knee joint Injury to the infrapatellar branch of the saphenous nerve (IBSN) is a relatively common complication after knee surgery, which can interfere with patient satisfaction and functional outcome. In some c..

Nerve damage can also occur after knee replacement surgery because the peroneal nerve resides close to the fibula bone, and can become compressed or damaged. In fact, nerve damage is one reason why some people have persistent lateral knee pain and loss of function in the foot or to the top or side of the foot after a newly replaced knee Background Perioperative nerve injury (PNI) is one of the most debilitating complications after total knee arthroplasty (TKA). Although regional anesthesia (RA) techniques reduce pain and improve functional outcomes after TKA, they may also contribute to PNI The biggest symptoms of nerve damage after surgery are usually numbness, tingling, burning, or muscle weakness or atrophy. Many times nerve issues after surgery are temporary, for example, many patients have nerve problems after surgery that only last for a few weeks to months (2,3) Purpose: Injury to the infrapatellar branch of the saphenous nerve (IBSN) is a relatively common complication after knee surgery, which can interfere with patient satisfaction and functional outcome.In some cases, injury to the IBSN can lead to formation of a painful neuroma. The purpose of this study was to report the results of surgical treatment in a series of patients with IBSN painful. Decompression of the saphenous nerve involves the release of the vastoadductor intermuscular septum. In this case, the patient presented with severe pain in the lower extremity and diagnosed with complex regional pain syndrome. Her neuropathic pain began seven-years-ago following a revision knee operation for knee stiffness

A brief physical exam confirmed that the saphenous nerve was being compressed or pinched deep in the inner thigh in a tight space called the adductor canal. Using local anesthetic, Dr. Tollestrup put to sleep the small sensory nerves causing the pain in the area of the left knee The authors wrote, A retrospective analysis of 94 thigh-knee MRI studies was performed to determine the relationship between the width of the distal femur at the epicondylar axis and the proximal location of the saphenous nerve after its exit from the adductor canal and separation from the superficial femoral artery Current opinion suggests that in some patients, chronic pain after total knee arthroplasty (TKA) has a neuropathic origin. Injury to the infrapatellar branch of the saphenous nerve (IPSN) has been implicated as a cause of medial knee pain; however, local treatments for this condition remain controversial

Infrapatellar Saphenous Neuralgia - Pain Physicia

So if after an ACL reconstruction, there is numbness or tingling in this area of the knee and/or shin, it is most likely due to damage to the saphenous nerve. For some people, the area of skin that feels numb is in the shape of a circle, close to the incision site. Normally, the only issue that this causes people is an odd feeling when kneeling Nevertheless, it is possible to have significant pain in an area of a large varicosity, since it is prone to thrombosing, especially if you were not wearing a compression stocking. Pain below the puncture site can also indicate some thermal injury to the saphenous nerve, but your description of symptoms is not a classic one TOTAL knee arthroplasty is one of the most common lower extremity surgeries performed in the United States for progressive pain caused by severe arthritis. Anesthetic management for postoperative pain includes intermittent intravenous opioids and patient-controlled analgesia as well as peripheral nerve blockade Blocking the function of the saphenous nerve (a technique known as a saphenous nerve block) is one the methods used for controlling pain after knee and foot surgery. Another closely related method is the femoral nerve block. However, the femoral nerve innervates several muscles in the thigh, and blocking this nerve may result in temporary. Most of the time the damage to the saphenous nerve causes numbness rather than pain and is transient (so it should be resolving or improving with time). I would have a thorough discussion with your provider regarding all possible explanations. Vein Center of Orange County Published on Jul 28, 201

Saphenous neuritis: a poorly understood cause of medial

Injury to the infrapatellar branch of the saphenous nerve (IPSN) has been implicated as a cause of medial knee pain; however, local treatments for this condition remain controversial. Questions/purposes: We sought to explore the efficacy of local treatment to the IPSN in patients with persistent medial knee pain after TKA This nerve has been blocked near the knee joint by way of infiltration by surgeons and anesthetists, for relief of pain after knee surgery, with varying pain relief of postoperative pain. When we block the saphenous in the mid thigh in the sartorial canal, the fluid tends to block the medial branch of the anterior femoral cutaneous nerve also The saphenous nerve is a terminal branch of the femoral nerve that provides sensory innervation to the soft tissues and skin of the anterior and medial lower extremity. 1 Its course is relatively direct as it branches from the femoral nerve in the thigh coursing medially and accompanying the descending genicular artery through the adductor.

Knee-replacement surgery offers the hope of returning to typical duties and physical activities without having to deal with debilitating pain 1. And while elimination of pain is part of the goal of surgery, the surgery itself presents its own pain possibilities, especially in regards to the sciatic nerve and complications that may arise after a full knee replacement 17 months ago, i still have lots of pain. my doctor recently told me i have saphenous nerve damage and is going to try ? Answered by Dr. Richard Zimon: Looks like: your question is incomplete Is it a SAPHENOUS NERVE BLOCK?..

Keywords: Infrapatellar branch, Saphenous nerve, Neuroma, Neurolysis Introduction The infrapatellar branch of the saphenous nerve (IBSN) is a small nerve that originates at the medial aspect of the knee and provides sensation to the area of the tibial tuberosity without a motor component [1, 2]. The sa-phenous nerve, a branch of the femoral. Saphenous Neuralgia. Saphenous Neuralgia is an uncommon nerve problem that causes pain on the inside of the knee. It is a branch of the femoral nerve with contributions from the L3 and L4 nerve root. The pain from saphenous neuralgia is described as burning, is located on the medial (inside) portion of the leg and is often worse at night Injury to the infrapatellar branch of the saphenous nerve (IPBSN) is a high-frequency complication in anterior cruciate ligament (ACL) reconstruction. We analyzed the risk factor of IPBSN injury in ACL reconstruction. Moreover, we investigated the influence on treatment outcome by this complication. One hundred twenty-three patients who underwent ACL reconstruction using semitendinosus tendon. Injury to these nerve branches may be a cause of unexplained pain after knee surgery and can be confirmed when the pain resolves after an ultrasound guided block to the saphenous nerve. Surgical exposure of the nerve may be required for patients with persistent pain and altered sensation that is resistant to physical therapy strategies

Nerve Damage Basics Knee pain may be a sign of nerve damage. The body's nervous system is a complex series of chemical signals that course along the nerve pathways bringing messages about sensation and pain to and from the brain.Damage can happen almost anywhere, and is usually a result of injury or trauma demonstrated efficacy in the treatment and prevention of neuroma pain. The objective of this study was to describe the surgical technique for TMR of the saphenous nerve, while providing a retrospective review. Between January 2015 and December 2018, 18 patients underwent TMR of the saphenous nerve: 1 nonamputee patient with chronic pain after ankle surgery and 17 amputee patients (10 for. Symptoms of entrapment of the saphenous nerve may include knee pain. Nerve entrapment can occur when a nerve is repeatedly compressed over a long period of time, and the saphenous nerve is especially prone to entrapment in many different locations because of its length. Symptoms of entrapment of this nerve may include knee pain, an aching in the thigh or numbness in the leg and foot Background. Total knee arthroplasty (TKA) is a common procedure resulting in significant post-operative pain. Percutaneous cryoneurolysis targeting the infrapatellar branch of the saphenous nerve and anterior femoral cutaneous nerve could relieve post-operative knee pain by temporarily blocking sensory nerve conduction Saphenous Nerve Neuropathy. Any mechanical compression of the saphenous nerve can cause injury of the vessels and nerves creating pain or numbness or burning. This is known as saphenous neuralgia. The most common points of saphenous nerve compression or injury are the inner knee and distal ankle

On the date of surgery, the patient was placed under general anesthesia. Thereafter, a physician's assistant endoscopically attempted to remove from the patient's leg the necessary saphenous vein. The harvesting procedure began by the physician's assistant making an incision just below the patient's knee Chronic knee pain continues to cause increasing levels of functional deficits, mobility issues, and decreased quality of life in the United States. Initial treatment for knee pain consists of physical therapy, weight loss, medication management, injections, and radiofrequency ablation (RFA). Definitive treatment usually requires surgical management. Peripheral nerve stimulation (PNS) has been. OBJECTIVES: Arthroscopic knee surgery is a minimally invasive technique with moderate pain during the first 24h. Our main objective was to evaluate the efficacy of ultrasound guided saphenous nerve block as a method of pain control intraoperatively and postoperatively for this surgery Dan Cavallari A diagram of the knee. Treatments for nerve damage in the knee depend on the cause of the nerve damage. In many cases, the damage is caused by some sort of trauma or daily habit that puts excess pressure on the nerve or nerves that service the area. Identifying the cause can help a sufferer come up with an effective plan for reducing pain and swelling and restoring mobility and.

Your anesthesiologist may offer you one or more nerve blocks to help you feel less pain after your surgery. Examples include the femoral nerve block and adductor canal (saphenous nerve) block.What Is a Nerve Block? Femoral Nerve Block. A femoral nerve block is often used to help with pain relief after total knee replacement VAS Pain value on day 15 after the knee replacement surgery. The Visual Analog Scale to assess pain ranges from 0mm to 100mm, where 0 is the 'absence of pain' and 100 is 'the worst pain imaginable by the patient'. Lower values in the scale represent a better outcome for the patient jury to the infrapatellar branch of the saphenous nerve in ACL reconstruction with the hamstrings technique: clinical and electrophysiological study. Knee. 2008;15(5):360-363. 2. Sanders B, Rolf R, McClelland W, Xerogeanes J, Sanders B, Rolf R, et al: Prevalence of saphenous nerve injury after autog A surgeon may accidentally injure the saphenous nerve located near the kneecap during surgery. Research shows that most people who have surgery-related knee numbness experience it on the outer. Injury to the saphenous nerve can cause an explosive feeling and pain near the knee and inner leg. Supposedly, ablation of this nerve is being proposed to get rid of this pain. Find someone at a prestigious institution like the Cleveland Clinic or Mayo Clinic to see if this ablation would indeed help you

It is for this reason the saphenous nerve block does not provide as good analgesia after knee surgery as the conventional femoral block at the inguinal level. The clinical relevance of these proximally arising femoral sensorynerves in terms of mediating pain after knee surgery (compared to the saphenous nerve) is at present unknown Saphenous neuritis as it is commonly known as (also Gonalgia Paresthetica ) is a chronic irritation of the saphenous nerve. This pathology is caused by a compression or irritation of the saphenous nerve which develops pain in many cases on the anterior side of the knee or on the medial side of the knee Case report Early-onset severe neuromatous pain of the infrapatellar branch of the saphenous nerve after total knee arthroplasty Kanto Nagai a,*, Hirotsugu Muratsu a, Tomoyuki Matsumoto b, Isao. 1 Introduction. Saphenous neuralgia describes the symptom complex which includes anaesthesia, hyperaesthesia and pain within the distribution of the saphenous nerve. This sensory nerve is closely related to the great saphenous vein during its subcutaneous course through the medial aspect of the leg, and the continuity of the nerve and its branches are at risk during any surgical procedure in. The saphenous nerve is in particular danger during operations on varicose veins. 3 Removal of the saphenous vein for use as an arterial graft poses the same risk. 4, 5 Saphenous nerve damage occurred in 3% of 421 patients in one operative study. 6 Cannulation of the saphenous vein at the ankle may injure the nerve and produce permanent painful paraesthesiae.

Can you suggest pain relief for foot pain after vein surgery? - I had bilateral RFA of both greater saphenous veins in 2007 and am on coumadin for continued LE ulceration. I have significant foot pain, particularly when I first stand. I wear compression hose. Ideas for relief Berg and Mjoberg 6) recommended the use of a lateral incision rather than a medial incision for cruciate ligament surgery of the knee joint. The anatomy of the saphenous nerve arises from the posterior division of the femoral nerve in the proximal thigh

Persistent anterior knee pain, especially after surgery, can be very frustrating for the patient and the clinician. Injury to the infrapatellar branch of the saphenous nerve (IPS) is not uncommon after knee surgeries and trauma, yet the diagnosis and treatment of IPS neuralgia is not usually taught in pain training programs We assessed pain management safety and efficacy after TKA, using intra-articular infiltration associated with peripheral saphenous nerve block (SNB) vs intra-articular infiltration alone. Methods We performed a controlled, double-blinded, and randomized trial to evaluate postoperative pain in TKA Introduction. Anterior knee problems such as anterior knee pain, tenderness, crepitus, disturbed sensitivity, and inability to kneel or knee-walk after anterior cruciate ligament (ACL) reconstruction are common and, although they occur more often when patellar tendon autograft is used, they can be seen with other graft options as well Nerve ablation knee treatment is a new way to help relieve pain. However, please understand that the most commonly used procedure kills the nerve through heat and that complications are possible. As a result, you may want to consider procedures that can help repair the damaged knee structures rather than kill the nerves To conclude, this meta-analysis suggests that saphenous nerve block has an advantage in pain relief both at an active flexion of knee and at rest after knee surgery. Further studies are still wanted to validate these conclusions

Saphenous Neuropathy Following Medial Knee Traum

Historically, saphenous nerve blocks were performed as cutaneous field blocks using an above-the-knee femoral paracondylar approach or below the knee using the greater saphenous vein as a landmark. In 1993, van der Wal et al demonstrated a more proximal method of blocking the saphenous nerve using a landmark-based, loss-of-resistance. i two had nerve damage after tkr and my pain was the top outside ankle and top outside foot. after 3 months of this pain went to pain management and got some lyrica and has help me to go forward with strengthening the muscle in the leg. also went to a nerulogist to have emg done to see how much nerve damage was done, it came back that the nerve. Nerve blocks and nerve sheath catheters offer a means to control post-operative pain. As part of the recovery following your upcoming surgery, you will use a peripheral nerve block catheter and infusion pump to help reduce pain. A nerve block can be used for surgery on the shoulder, elbow, forearm, wrist, hand, fingers, knee, leg, ankle, or foot

Further, pain and opioid requirements were evaluated in eight patients receiving a continuous blockade of the saphenous and obturator nerve (adductor-canal-blockade) after total knee arthroplasty (TKA). Finally, we performed cross-sectional MR scans of the adductor canal after injection of ropivacaine 30 ml in one patient Pain in the immediate post- can be blocked to reduce the level of pain after knee surgery. operative period, becomes a barrier for starting an early Free nerve endings are most numerous in the synovial rehabilitation programme after anterior cruciate ligament coverings of the cruciate ligaments, patellar ligament, pes reconstruction surgery. Tsai et al (2010) noted that the saphenous nerve, a branch of the femoral nerve, is a pure sensory nerve that supplies the antero-medial aspect of the lower leg from the knee to the foot. There is limited evidence of the effectiveness of US-guided techniques to block the saphenous nerve In addition, variable contributions from the saphenous nerve and the lateral femoral cutaneous nerve provide sensory innervation to the medial and lateral aspects of the knee, respectively. [1,2] These nerves and their respective tributaries are common targets for peripheral nerve blockade

Saphenous Nerve Injury

Pain in the front of the knee after the surgery is commonly associated with patellar tendon graft but may also occur in cases of allograft and quadriceps tendon graft. The pain may occur due to noncompliance with postoperative rehabilitation protocol. ACL reconstruction is a safe surgery and the associated complications are rare Pain after ELVT occurs and is related to the type of laser used, the size of the vein, the amount of energy used and the performance of any other procedures (Phlebectomy). The big knot may be a hematoma, a blood clot or the residue of a Phlebectomy. If the vein was closed below the knee, pain and inability to bend the knee joint are common Levobupivacaine 0.25% 15 mL in adductor canal nerve block. Other Name: Chirocaine. Experimental: D Levobupivacaine 20 mL. Adductor canal nerve block with levobupivacaine 0.25% 20 mL and perineural catheter placement, an elastomeric pump with bupivacaine 0.1% at a rate of 5 ml/hr will be placed after surgery for continuous nerve block Meralgia Paresthetica. -compression of the lateral femoral cutaneous nerve. -pain & tingling sensation but no motor loss. -cause: obesity, postural changes, tight clothing/seatbelt/toolbelt, pregnancy. Lateral cutaneous nerve of thigh origin and sensation. L2-3

° Cephalic vein ° Popliteal vein ° Femoral vein ° Great saphenous vein Question 58 A football player complains of severe knee pain after being tackled from the side. When the knee is flexed, the tibia can be moved anteriorly relative to the femur Knee Hero: Sollievo Immediato Dai Dolori E Dal Malessere! Knee Hero: Proteggi e Prenditi Cura Delle Tue Ginocchia Ogg Saphenous nerve block has been tested and suggested for knee surgery in a few case studies [2-4]. Several recent randomized controlled trial (RCT) found that a saphenous nerve block reduced pain during knee flexion, and reduced morphine consumption during first 24 hours after meniscectomy [5,6], and after total knee arthroplasty (TKA) [7-9]. It. The saphenous nerve can also be indirectly affected via lumbar disc disease, meniscal tear, or post-surgery. Most commonly during a total knee replacement. Saphenous Nerve entrapment is described as pain on the inside of the thigh, knee, or calf. The pain is described as dull and achy pain and it may have a burning or electric type feel

Medial Knee Reconstructions and the Satorial Branch of the Saphenous Nerve Medial Plica Irritation: Diagnosis and Treatment Popliteomeniscal Fascial Tears Causing Symptomatic Lateral Compartment Knee Pain Anterior Intermeniscal Ligament of the Knee - An Anatomical Study Right Knee Surgery After Auto Bicycle Accident Preferably use horizontal incisions to reduce the risk of injuring the infrapatellar branch of the saphenous nerve. In conclusion, anterior knee pain following intramedullary nail surgery is fairly common. Even though the exact cause is not known, it is believed that the entry point of this implant into the bone may have a role to play Nerve pain in my knee after surgery, it was called a neuroma. I recently had knee surgery to repair my ACL in my left knee (for the 2nd time). The Doctor too the Petella graft from my right knee. The surgery was done in March 07. Shortly after the surgery during my Physical Therapy I started having pain in my right knee

Peripheral Nerve Stimulation Helps Knee Pain After Surgery. To see if you're a candidate for peripheral nerve stimulation, you will first get a temporary nerve block to decide if this controls knee pain after surgery. If the block reduces your pain by at least 70 percent, you could be a candidate for a PNS trial Needles placed on the inner side of the knee could contact either the Saphenous Nerve, or more likely, the Infrapatella branch of the saphenous nerve. The later of the two crosses from the inner side of your knee to the outer side. Therefore if that nerve is injured, or upset then you can feel pain on the opposite side of the knee

Neuroma of the Infrapatellar branch of the saphenous nerve

Anterior knee pain is common after total knee arthroplasty. The incision necessarily travels through the path of a cutaneous nerve - branches of the saphenous nerve. Historically, no effort has been made to separate these branches and bury them away from the surgical scar Conclusions: The infrapatellar branch of the saphenous nerve is at risk for iatrogenic damage in anteromedial knee surgery, especially when longitudinal incisions are made. There are three low risk zones for a safer anterior approach to the knee. The direction of the infrapatellar branch of the saphenous nerve is location-dependent Background Adductor‐canal‐blockade is a new technique for pain relief after knee surgery. This block could cause nerve injury and the aim of this follow‐up study was to determine the prevalence of. Background. Adductor‐canal‐blockade is a new technique for pain relief after knee surgery. This block could cause nerve injury and the aim of this follow‐up study was to determine the prevalence of saphenous nerve injury in patients receiving adductor‐canal‐blockade for pain treatment after total knee arthroplasty

Management of Chronic knee pain caused by postsurgical or p

4) In particular, femoral nerve block is often considered the gold standard for pain relief after total knee arthroplasty. 4, 5) However, femoral nerve block reduces quadriceps muscle strength and compromises early ambulation and rehabilitation. Moreover, it has been associated with higher risks of falls Saphenous nerve block is not only popular for anesthesia during procedures, but also for treating pain after certain procedures. Recently it has been demonstrated that it can be an effective technique to control pain after knee surgery. Though the saphenous nerve can be blocked at various locations such as above the knee, below the knee, at the.

Still Have Pain After Knee Surgery Dr

Figure 4. Infrapatellar branch of saphenous nerve showing the 3 branches (arrows). Figure 5. Infrapatellar branch of saphenous nerve during injection of bupivacaine solution. Figure 6. Infrapatellar branch of saphenous nerve after excision of the neuroma. The Orthopaedic Journal of Sports Medicine Infrapatellar Pain Syndrome The saphenous nerve block is gaining popularity not only for procedural anesthesia but also for treatment of pain after procedures. [ 2 , 3 ] Its use has been demonstrated to be an effective regional technique for post-meniscectomy pain Single port, select-a-flow pump and ON-Q 750mL ball filled with bupivacaine 0.125% saphenous (adductor canal) nerve block and single port, fixed flow pump and 400mL ON-Q ball with bupivacaine 0.125% wide field posterior knee block to provide analgesia from surgery until medication has been depleted (typically 2-4 days Saphenous nerve entrapment is rare, but it is often overlooked during the differential diagnosis process for infra patella knee pain. The use of observation, palpation, and selective tissue tension techniques can help you with the diagnosis The saphenous nerve can be seen to move from the side of the femoral artery to its top surface as the probe slides from proximal to distal. This is most clearly seen after injection of local anesthetic for regional block. After most approaches to saphenous nerve block the medial leg and foot will show signs of cutaneous anesthesia

Perioperative Nerve Injury after Total Knee Arthroplasty

Further, pain and opioid requirements were evaluated in eight patients receiving a continuous blockade of the saphenous and obturator nerve (adductor‐canal‐blockade) after total knee arthroplasty (TKA). Finally, we performed cross‐sectional MR scans of the adductor canal after injection of ropivacaine 30 ml in one patient Saphenous. Nerves may be compressed from tight ligaments, inflamed tendons, tumors, fracture fragments, varicose veins, scar tissue or injuries to the foot that cause the foot and ankle to be misshapen (severe flatfoot). Nerve compression may cause significant discomfort with weightbearing. Night pain and pain while the patient is.

Nerve Damage after Surgery: What Are Your Options

Chronic, non-surgical, non-specific anterior knee pain is a common source of functionally limiting chronic ailment, especially in a young athletic and active-duty military population. The infrapatellar branch of the saphenous is becoming a common therapeutic target for the diagnosis and treatment of anterior knee pain. It is a nerve commonly injured during knee surgeries and trauma, resulting. Background: After knee surgery, analgesia should be effective for mobilization and discharge. Aim of the Study: The primary objective of this study was to achieve the lowest effective analgesic concentration (MEC50 and MEC90) of ropivacaine for saphenous nerve block in arthroscopic meniscectomy. The secondary objective was to determine whether. Individuals experiencing saphenous nerve entrapment will most often have knee pain, especially after working out their quadriceps. The pain could also be present at night and could be a burning pain. Treatment for saphenous nerve problems include injections of medications or even destruction and/or removal of the infrapatellar ranches of the nerve The femoral nerve block (FNB) is a well-established and effective method of targeted pain control for any procedure involving the anterior knee. Providing effective analgesia after knee surgery is essential both for patient satisfaction and functional recovery, yet remains challenging to accomplish. The femoral nerve block (FNB) is a well. Median pain scores (0-10) on active flexion of the knee joint to 45° for 24 h after ambulatory knee arthroscopy: 59 participants received saphenous and obturator (posterior branch) nerve blocks with ropivacaine or saline (). No significant difference between groups at individual time points

Figure 4 from Infrapatellar saphenous neuralgiaLower Extremity Nerve Entrapment | Musculoskeletal KeyNumb area after TKR: how long will it last? | JointUltrasound-Guided Saphenous (Adductor Canal) Nerve BlockThe superficial anatomy of the medial knee (modified fromThe anatomy and pattern of pain of the saphenous nerve at

The saphenous nerve is also often damaged during vein harvest for bypass surgery and during trocar placement during knee arthroscopy. There appears to be occasional meaningful individual variation in the pathway of this nerve, such that the illustration of it done for Gray's Anatomy , for example, likely represents an unusual rather than usual. lower leg and foot.17 Saphenous nerve block has been tested and suggested for knee surgery in a few case studies.18Y20 A recent randomized controlled trial (RCT) found that a con-tinuous saphenous nerve block reduced pain during knee flex-ion and reduced morphine consumption during the first 24 hours after TKA.21 The saphenous nerve can be. Journal of Observational Pain Medicine 2015;1(5):22-28. González Sotelo V, Maculé F, Minguell J, Bergé R, Franco C, Sala-Blanch X. Ultrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note. Rev Esp Anestesiol Reanim 2017 Dec;64(10):568-576 If our study proves the saphenous nerve block to be an effective method of postoperative pain control without compromising quadriceps strength, it would be seen as a better alternative to femoral nerve blocks. Inclusion/Exclusion Criteria. Inclusion Criteria All patients ages 40-80 undergoing primary bilateral total knee arthroplast Neuritis of the infrapatellar branch of the saphenous nerve can result from iatrogenic injury, entrapment, bursitis, or patellar dislocation. Currently, there is an unmet clinical need for treating refractory neuritis nonsurgically. Three patients presented with persistent anterior knee pain caused by neuritis of the infrapatellar branch of the saphenous nerve that had got excellent but only.