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Suprapatellar branch of the saphenous nerve
10%
191/1857
Infrapatellar branch of the saphenous nerve
82%
1532/1857
The common peroneal nerve
2%
39/1857
The superficial femoral nerve
35/1857
The lateral femoral cutaneous nerve
3%
51/1857
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Injury to the infrapatellar branch of the saphenous nerve (IBSN) during ACL reconstruction is common and can lead to numbness and paresthesias over the anterolateral aspect of the knee and proximal leg. It can also be a cause of anteromedial pain in the proximal stump. The saphenous nerve arises as a division of the femoral nerve and leaves the adductor canal between the tendons of the gracilis and sartorius. It then divides into the main saphenous branch and the infrapatellar branch which crosses the knee below the patella. Therefore, it can be injured when making the incision for the tibial tunnel or when harvesting hamstring or patellar tendon grafts. Injury to the IBSN can result in anteromedial pain and decreased sensation over the anterolateral infra-patellar area of the knee and leg. Portland et al noted that the IBSN is often injured with the traditional vertical incision for central patellar tendon harvest. They suggest that a horizontal incision may result in a lower injury rate but is technically more challenging. Illustration A shows a right leg with the infrapatellar branch of the saphenous nerve tagged.
4.1
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