Methods: Common to all 20 patients is that their pain was present for at least 9 months (9m-2.7y) and that all conservative pain modalities failed to provide relief. Three patients had nerve compression at the adductor canal (one idiopathic, two following blunt trauma). Two patients had nerve exposed in open wound (sickle cell), five patients had pain due to orthopaedic procedures in the lower extremity and foot, while ten had pain following knee surgery. All patients had moderate to major quality of life issues due to the pain. Patients who had nerve compression at the adductor canal were decompressed, while patients with post-op neuroma along the course of the nerve had excision of the nerve proximal to the site of the injury and implantation to the muscle.
Results: Patient's had an average 2-year follow up (range 1.4-2.9 years). Pre-operative average VAS pain level was 7.4 (with ten on direct stimulation of the neuroma site), while post-operatively it dropped to an average of 2.3 (p<0.009). 17 out of 20 patients (85%) reported that they had 50% or more pain relief. Two patients (10%) reported 40-50% pain relief and another one patient (5%) reported no improvement. The quality of life improvement reported 18 patients (90%).
Summary: Patients with saphenous nerve neuropathy can successfully be treated with peripheral nerve surgery. Since no treatment algorithm is reported yet for saphenous nerve neuropathy, it will be presented, together with indications for the type and the timing of the surgery for a given chronic pain problem related to the saphenous nerve.