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髌下支隐神经:慢性膝关节疼痛的治疗方法。

Infrapatellar Branch of the Saphenous Nerve: Therapeutic Approaches to Chronic Knee Pain.

机构信息

Anesthesiology Department, University of Wisconsin, 600 Highland Avenue, Madison, WI, B6/319 CSC, USA.

University of Wisconsin, Madison, WI, USA.

出版信息

Curr Pain Headache Rep. 2024 Apr;28(4):279-294. doi: 10.1007/s11916-024-01217-7. Epub 2024 Jan 31.

Abstract

PURPOSE OF REVIEW

The infrapatellar branch of the saphenous nerve (IPS) is an under-investigated nerve that can be a source of chronic knee pain. This literature review aims to deliver an up-to-date review of chronic pain transmitted via the IPS along with therapeutic approaches available for pain refractory to conservative measures.

RECENT FINDINGS

Knee pain transmitted via the IPS can arise from several etiologies. Damage to the IPS is often iatrogenic and develops following total knee arthroplasty, anterior cruciate ligament reconstruction, and other knee surgical procedures. Other causes of IPS-derived pain include entrapment of the nerve, neuromas, Schwannomas, and pain from knee osteoarthritis transmitted through the IPS.This article investigated therapeutic approaches to pain derived from the IPS. Common approaches included radiofrequency ablation, neuroma excisions, Schwannoma excision, nerve blocks, surgical exploration, surgical release of an entrapped nerve, cryoablation, and peripheral nerve stimulation. Pain scores, duration of pain relief, adverse events, and secondary outcomes were all included in this review. A subset of the patient population experiences chronic pain deriving from the IPS that is refractory to conservative treatment measures. This review aims to evaluate the etiologies and therapeutic approaches for chronic pain arising from the IPS refractory to conservative treatments.

摘要

目的综述

隐神经髌下支(IPS)是一条研究不足的神经,它可能是慢性膝关节疼痛的根源。本文旨在对经 IPS 传递的慢性疼痛及其对保守治疗无效的疼痛的治疗方法进行最新综述。

最近的发现

经 IPS 传递的膝关节疼痛可能由多种病因引起。IPS 损伤通常是医源性的,发生在全膝关节置换术、前交叉韧带重建术和其他膝关节手术后。IPS 源性疼痛的其他原因包括神经卡压、神经瘤、雪旺细胞瘤和经 IPS 传递的膝骨关节炎疼痛。本文探讨了源自 IPS 的疼痛的治疗方法。常见的方法包括射频消融、神经瘤切除术、雪旺细胞瘤切除术、神经阻滞、手术探查、受困神经的手术松解、冷冻消融和外周神经刺激。疼痛评分、疼痛缓解持续时间、不良事件和次要结果均包含在本次综述中。一小部分患者人群经历了源自 IPS 的慢性疼痛,这些疼痛对保守治疗措施具有抗药性。本综述旨在评估对保守治疗无效的源自 IPS 的慢性疼痛的病因和治疗方法。

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