ArticlePain medicine (Malden, Mass.)2025
A comparative 3D anatomical simulation study of four techniques to ablate the infrapatellar branch of the saphenous nerve.
Article in Pain medicine (Malden, Mass.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundImage-guided radiofrequency ablation of the superior and inferior medial genicular nerves is used to treat medial knee pain. The infrapatellar branch (saphenous nerve) has been suggested as an additional nerve target. No studies have assessed nerve capture rates of the techniques.
objectiveTo simulate four radiofrequency ablation techniques (cooled/long-axis/conventional bipolar strip lesion/dual-tined techniques) to (1) visualize the lesions in 3D relative to the treatment line and compare their extent; (2) determine and compare capture rates of the infrapatellar branch and inferior medial genicular nerve; and (3) assess which technique(s) would be most effective.
designAnatomical simulation study.
methods3D models were reconstructed, based on previously collected data of the dissection/digitization of 7 specimens. Four techniques were simulated with lesion sizes obtained from previously published data or manufacturer's specifications. Capture rates of the infrapatellar branch and inferior medial genicular nerve were compared and the extent of the lesion relative to the treatment line was visualized.
resultsThe cooled monopolar technique resulted in over 50% capture rate of the superior infrapatellar branch and anterior branch of inferior medial genicular nerve. This was followed by the dual-tined monopolar technique, capturing 42.9% of superior infrapatellar branch and 57.1% of anterior branch of inferior medial genicular nerve. The simulated lesions did not always encompass the treatment line inferiorly, sparing the inferior infrapatellar branch. All techniques resulted in complete sparing of the infrapatellar branch in some specimens.
conclusionsHigh-fidelity lesion simulation of radiofrequency ablation techniques provides a robust anatomical foundation to inform image-guided interventions for medial knee pain.
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