Investigation of the existence of and a block technique for the inferior lateral genicular nerve: cadaveric study

Korean J Pain. 2023 Jul 1;36(3):328-334. doi: 10.3344/kjp.23112. Epub 2023 Jun 22.

Abstract

Background: Among the four genicular nerves innervating the anterior aspect of the knee, the inferior lateral genicular nerve has been omitted as a target of blocking. Some authors have suggested that the inferior lateral genicular nerve of the knee might pass beneath the lateral collateral ligament of knee. The authors aimed to study the location of the inferior lateral genicular nerve and the spread of injectate during the inferior lateral genicular nerve block.

Methods: In ten knees from fresh frozen cadavers, the authors performed on each an ultrasound-guided block of the inferior lateral genicular nerve of the knee just below the lateral collateral ligament. The needle was inserted below the lateral collateral ligament, and 2 mL of blue dye was injected. A week later, the cadavers were dissected, and the existence of the inferior lateral genicular nerve and the spread of dye around it was investigated.

Results: The proportion of inferior lateral genicular nerves branching from the common peroneal nerve was found in 8 of 10 (80.0%) cadavers. Of these eight cadavers with inferior lateral genicular nerve, five specimens (62.5%) were stained with blue dye. The common peroneal nerve was not infiltrated with dye in any specimens.

Conclusions: When 2 mL of dye was inserted inferiorly to the lateral collateral ligament, the inferior lateral genicular nerve could be blocked in 62.5% of specimens. Because the common peroneal nerve was not involved in any specimen, motor weakness would be avoided with this method.

Keywords: Cadaver; Genicular Nerve; Knee Joint; Nerve Block; Osteoarthritis, Knee; Pain Management; Peroneal Nerve; Ultrasonography, Interventional.

Grants and funding

FUNDING This research was supported by the Research Fund of Seoul St. Mary’s Hospital, The Catholic University of Korea. Support was provided solely from institutional sources.