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Application of saphenous nerve infrapatellar branch protection technique in total knee arthroplasty
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Application of saphenous nerve infrapatellar branch protection technique in total knee arthroplasty
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Journal Article
Application of saphenous nerve infrapatellar branch protection technique in total knee arthroplasty
2025
Overview
Objective
This randomized controlled trial conducted a comparative analysis of postoperative outcomes between a modified anteromedial incision with saphenous nerve protection and the traditional medial parapatellar approach in total knee arthroplasty (TKA). We aimed to test the hypothesis that the nerve-sparing modified technique would significantly reduce postoperative anterior knee numbness and pain while maintaining surgical feasibility.
Methods
Sixty-eight TKA candidates (January 2022-June 2023) were prospectively randomized into two groups: Modified (
n
= 34) and Traditional (
n
= 34) approaches. The modified technique featured an anteromedial incision with infrapatellar branch visualization and preservation, whereas the control group received the traditional medial parapatellar exposure. Primary outcomes included numbness area and the Visual Analog Scale score; secondary outcomes encompassed surgical parameters (duration, blood loss) and functional recovery (Hospital for Special Surgery Knee score).
Results
Thirty one patients were randomized to the M group and 29 patients allocated to the T group. Compared to the T group, the M group demonstrated significantly lower VAS scores at 3 days, 7 days, and 2 weeks postoperatively, with statistical significance (
P
< 0.05). The M group showed a statistically significant reduction in the area of numbness compared to the T group at all postoperative follow-up intervals: 2 weeks, 1 month, 3 months, 6 months, and 1 year (
P
< 0.05 for all time points). However, postoperative HSS scores did not differ significantly between the M group and the T group at any follow-up interval (
P
> 0.05).
Conclusion
The nerve-preserving modified approach achieved superior patient-reported outcomes (PROs) in reducing anterior knee numbness and early postoperative pain without compromising prosthesis implantation accuracy or functional recovery trajectories, suggesting its potential as a standardized refinement in TKA surgical protocols.
Trial registration
Chinese Clinical Trial Registry, ChiCTR2500107220, 6 August 2025, retrospectively registered.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Arthroplasty, Replacement, Knee - adverse effects
/ Arthroplasty, Replacement, Knee - methods
/ Female
/ Humans
/ Hypesthesia - prevention & control
/ Knee
/ Male
/ Medicine
/ Pain
/ Pain, Postoperative - etiology
/ Pain, Postoperative - prevention & control
/ Patients
/ Skin
