Saphenous nerve compression in the differential diagnosis of knee pain. Case study and a review of the literature.

A 17-year old male athlete presented with right knee and lower extremity pain that was resistant to traditional physical therapy and pain management for almost two years. He had played ice hockey as a goalie since childhood but was unable to return to play because of the pain. He had to a history of several different injuries to the same knee and had several MRI scans and physician visits without any help. Pain was aggravated by physical activity especially when the knee was extended but there was no major problem in the knee itself. Palpation of the adductor canal greatly aggravated the pain radiating below the knee. As local anaesthetic to the adductor canal eased the pain saphenous nerve impingement was suspected. Successful decompression of the nerve was performed and pain disappeared right after surgery. He was able to return to play ice hockey as a goalie three months after surgery. Even though iatrogenic injuries to saphenous nerve are common after orthopaedic operations, compression of the nerve in adductor canal is a rare condition that can cause problems in the differential diagnosis of knee pain. If needed, surgical treatment seems to yield a good outcome.