Scripties UMCG - Rijksuniversiteit Groningen
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Het effect van neurolyse bij ramus infrapatellaris neuropathie

(2016) Aalders, W.S.

Objective: Entrapment neuropathy of the infrapatellar branch of the saphenous nerve is generally an unknown and unfrequently diagnosed cause of knee pain. The aim of this study was to evaluate the efficacy of surgery used by plastic surgeons to treat this neuropathy: neurolysis of the infrapatellar branch.
Methods: A cohort of patiënts diagnosed with infrapatellar neuropathy was evaluated. Patiënts that received treatment were asked their pain scores (Numeral Rating Scale 0-10) before and after surgery, their global perceived effect, and the influence of this disease on their life in terms of working and sporting. Patients treated with neurolysis between September 2014 and Februari 2015 were also evaluated prospectively. Their pain score was evaluated using the visual analog scale (10-100mm). In addition, neural conduction was measured before and after surgery using somatosensory evoked potentials (SSEP).
Results: A total of 55 patiënts with infrapatellar neuropathy were evaluated, of which 50 patiënts were treated by neurolysis. 74 percent of the treated patiënts (n = 32) demonstrated a numeral rating scale reduction of at least 50% in the first 6 months. On the long term, 96 percent (n = 48) showed a numeral rating scale reduction of on average 4 in 12 months after surgery. The reduction in pain score in treated patiënts differs significantly from that of untreated patients. Prospectively, 2 patiënt were evaluated. Both showed a visual analog scale reduction of at least 50% in 3 months after surgery. With the used SSEP technique described in literature no results could be reproduced that indicate neural conduction impairment.
Conclusion: Surgical neurolysis as a treatment for infrapatellar neuropathy is effective in about two-thirds of the patiënts. In addition, almost all patiënts (96%) will retrieve a significant reduction in pain in a 12 months recovery period.

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