title: Saphenous neuropathy secondary to extraneural ganglion cyst 15 years after reconstruction of the anterior cruciate ligament.
abstract: This case report describes a 43-year-old woman with a previous anterior cruciate ligament reconstruction and medial meniscectomy who presented with right knee dysesthesias radiating into her medial ankle with associated allodynia. An extensive work-up was pursued, without a definitive diagnosis found or improvement in the patient's symptoms. Eventually, she was referred to Pain Medicine for an ultrasound-guided saphenous nerve (SN) block, where a scan before the injection revealed a large cyst anteromedial to the sartorius in the expected location of the SN. Magnetic resonance imaging and surgical pathology confirmed a juxta-articular ganglion cyst compressing the main SN, just above the take-off of the infrapatellar branch. The cyst was successfully resected, with improvement noted in the patient's neuropathic symptoms postoperatively. Saphenous neuropathy is a rare condition, and to our knowledge this case is the first reported of saphenous neuropathy caused by a knee joint capsule-derived ganglion cyst.
authors: Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First Street SW, Rochester, MN 55901(∗). Electronic address: Sole.joshua@mayo.edu.
authors: Joshua S
authors: JS
authors: Sole
authors: Department of Physical Medicine and Rehabilitation, and Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, MN(†).
authors: Matthew J
authors: MJ
authors: Pingree
authors: Departments of Neurologic Surgery and Orthopedic Surgery, Mayo Clinic, Rochester, MN(‡).
authors: Robert J
authors: RJ
authors: Spinner
authors: Department of Radiology, Musculoskeletal Division, Mayo Clinic, Rochester, MN(§).
authors: Naveen S
authors: NS
authors: Murthy
authors: Department of Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN(‖).
authors: Jacob L
authors: JL
authors: Sellon
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D005260:Female; D020428:Femoral Neuropathy / Q000209:etiology* / Q000601:surgery; D045888:Ganglion Cysts / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D017746:Joint Capsule / Q000473:pathology; D007719:Knee Joint / Q000294:innervation / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008592:Menisci, Tibial / Q000601:surgery