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Partial Denervation for Neuroma Pain after Knee Anterior Tibial Tuberosity Exostectomy: A Case Report
Cedric Ngbilo1,2, Eric Choudja Ouabo3, Biljana Jovanovic3
1Department of Orthopedic and Traumatology Surgery, CHUV, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Introduction:
Neuromas of the infrapatellar branch of the saphenous nerve (IBSN) can occur after direct trauma or surgical approaches to the anterior aspect of the knee. The purpose of this case report is to highlight the clinical presentation, diagnosis, and successful surgical management.
Case Report:
A 20-year-old patient who had a history of recent anterior knee surgery at another institution presented with allodynia, dysesthesia, and a positive Tinel's test over the surgical scar. The pain was exacerbated by light touch, was progressively worse, and was limiting sports participation and activities of daily living. A clinical diagnosis of neuroma of the IBSN was made and this was successfully treated by microsurgical neurolysis, resection of the neuroma, and burying of the stump. This resulted in complete resolution of pain.
Conclusion:
Neuromas of the IBSN can cause significant symptoms affecting activities of daily living. Microsurgical neurolysis is a useful treatment modality associated with complete resolution of pain and high patient satisfaction.
