TY - JOUR
T1 - Genicular Nerve Anatomy and Its Implication for New Procedural Approaches for Knee Joint Denervation
T2 - A Cadaveric Study
AU - Kim, Jung H.
AU - Shustorovich, Alexander
AU - Arel, Aaron T.
AU - Downie, Sherry A.
AU - Cohen, Steven P.
AU - Kim, Soo Yeon
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Objective: To verify the articular branch contributions in the human knee, delineate their anatomical variance, and outline the limitations of currently applied procedure protocols for denervation of the knee joint. Design: A detailed anatomical dissection. Setting: Cadavers in residence at the Albert Einstein College of Medicine. Subjects: In total, 24 lower extremity specimens from 14 embalmed cadavers. Methods: Human cadaveric dissections were performed on 24 lower extremities from 14 embalmed cadavers. Results: This cadaveric study has demonstrated that the anterior knee receives sensory innervations from SMGN, SLGN, LRN, NVI, NVL, RFN, and IMGN. The courses of SMGN, SLGN, RFN, and IMGN are similar to recent anatomical studies. However, discrepancies exist in their relative anatomy to bony and radiographic landmarks. Conclusions: Genicular denervation using classical anatomical landmarks may not be sufficient to treat the anterior knee joint pain. Our findings illustrate more accurate anatomic landmarks for the three-target paradigm and support additional targets for more complete genicular denervation. This cadaveric study provides robust anatomical findings that can provide a foundation for new anatomical landmarks and targets to improve genicular denervation outcomes.
AB - Objective: To verify the articular branch contributions in the human knee, delineate their anatomical variance, and outline the limitations of currently applied procedure protocols for denervation of the knee joint. Design: A detailed anatomical dissection. Setting: Cadavers in residence at the Albert Einstein College of Medicine. Subjects: In total, 24 lower extremity specimens from 14 embalmed cadavers. Methods: Human cadaveric dissections were performed on 24 lower extremities from 14 embalmed cadavers. Results: This cadaveric study has demonstrated that the anterior knee receives sensory innervations from SMGN, SLGN, LRN, NVI, NVL, RFN, and IMGN. The courses of SMGN, SLGN, RFN, and IMGN are similar to recent anatomical studies. However, discrepancies exist in their relative anatomy to bony and radiographic landmarks. Conclusions: Genicular denervation using classical anatomical landmarks may not be sufficient to treat the anterior knee joint pain. Our findings illustrate more accurate anatomic landmarks for the three-target paradigm and support additional targets for more complete genicular denervation. This cadaveric study provides robust anatomical findings that can provide a foundation for new anatomical landmarks and targets to improve genicular denervation outcomes.
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U2 - 10.1093/pm/pnab238
DO - 10.1093/pm/pnab238
M3 - Article
C2 - 34625814
AN - SCOPUS:85123388463
SN - 1526-2375
VL - 23
SP - 144
EP - 151
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 1
ER -