STRAIGHT, CURVED OR MINI-INCISIONS IN KNEE SURGERY: A HISTOPATHOLOGY COMPARISION AND REVIEW OF CUTANEOUS NERVE ANATOMY

Abstract

Cutaneous nerve injury occurs commonly with knee arthroplasty, causing altered skin sensation and, infrequently, the formation of painful neuromas. The infrapatellar branch of the saphenous nerve is the structure most commonly damaged.

The aim of this study was to establish the frequency of cutaneous nerve injury with three incisions commonly used in knee arthroplasty.

Ten knees from five cadavers were studied. Skin strips representing three different incisions, were excised and examined for number and thickness of nerves.

There were more nerve endings found in the dermis layer than the subcutaneous fatty layer. There was no significant difference in the total number of nerves when the 3 studied incisions were compared. The lower part of all incisions was found to have more thick and a higher number of nerves than the upper part (P=0.005).

Careful incision placement is required to avoid damage to cutaneous nerves during knee arthroplasty. This may be of long-term advantage to patients especially those for whom kneeling is important.