Article

The lateral retinacular nerve (LRN) is a branch of the superior
lateral genicular nerve (SLGN) and is believed to contribute to anterolateral
knee pain. The precise anatomical pathway of the LRN, however, has not been
demonstrated as it relates to the performance of targeted nerve block procedures.
OBJECTIVE: To describe the anatomical landmarks for localization of the LRN to
facilitate diagnostic and therapeutic nerve blocks in the treatment of chronic
anterolateral knee pain.
DESIGN: Descriptive study.
SETTING: Anatomy dissection
laboratory in an academic institution. METHODS: Twenty lower extremities were
dissected in 12 cadavers.
The sciatic nerve was identified, and its branch to the
posterior aspect of the knee, the SLGN, was dissected.
The SLGN dissection was
continued distally to identify its first branch, the LRN.
Two measurements were
taken from the branch point on the lateral knee deep to the distal biceps tendon
in alignment with the fibular head. A validation study completed in 4 knees was
performed as follows: 1 mL of colored dye was injected at the first and second
measurements. The cadaveric knee was then dissected to assess the accuracy. MAIN
OUTCOME MEASUREMENTS: Localization of the branch point of the LRN from the SLGN
via dissection and then direct assessment of injected dye at the measurement
points via dissection. RESULTS: The branch point of the LRN from the SLGN was, on
average, 5.5 +/- 0.66 cm (with a range of 4.5-7.0 cm) proximal to the lateral
tibiofemoral joint line in line with the head of the fibula and 2.6 +/- 0.62 cm
(2.0-4.5 cm) proximal to the tip of the lateral femoral epicondyle. On assessment
of the 2 measurements, the measurement 5.5 cm proximal to the lateral joint line
accurately targeted the branch point in 100% (4/4) of the knees, whereas the
measurement 2.6 cm proximal the tip of the lateral femoral epicondyle accurately
targeted the branch point in 75% (3/4) of the knees.
CONCLUSION: The results of
this study provide 2 dependable landmarks and a description of the path of the
LRN, making it possible to accurately target the LRN to diagnose and alleviate
lateral knee pain.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS