title: Development and validation of a new method for locating patella sensory nerves for the treatment of inferior and superior knee pain.
abstract: BACKGROUND
  Radiofrequency ablation and percutaneous cryoneurolysis to relieve knee pain requires treating large areas to ensure coverage due to high variability in the sensory innervation of the knee and limitations of current methods for defining treatment targets. This study sought to define and validate a new treatment approach targeting the major sensory nerves of the superior patella and expand upon previous work to define a more efficient treatment approach targeting the sensory nerves of the inferior patella.
  
  
  METHODS
  Transcutaneous electrical nerve stimulation and ultrasound were used to evaluate the location and relationship of the cutaneous nerves to the superior and inferior aspects of the knee in 25 healthy volunteers. Using information derived from these evaluations, investigators defined new linear target treatment areas, or treatment lines, using anatomical landmarks, which were validated against locations of sensory nerves through cadaveric dissection of 15 fresh specimens.
  
  
  RESULTS
  The proposed treatment lines captured the vast majority of nerve branching variations during cadaveric validation.
  
  
  CONCLUSIONS
  This study defined treatment lines, identifiable using only anatomical landmarks, which effectively target the nerves responsible for superior and inferior knee pain and reduce the total treatment area and procedure time when administering treatments such as radiofrequency ablation and cryoneurolysis.
authors.affiliation: myoscience, Inc., 46400 Fremont Blvd, Fremont, CA, 94538, USA. Emily.s.hu@gmail.com.
authors.forename: Emily
authors.initials: E
authors.lastname: Hu
authors.affiliation: myoscience, Inc., 46400 Fremont Blvd, Fremont, CA, 94538, USA. JPreciado@myoscience.com.
authors.forename: Jessica
authors.initials: J
authors.lastname: Preciado
authors.affiliation: Department of Orthopedics, Louisiana State University, 1542 Tulane Avenue, Box T6-7, New Orleans, LA, 70112, USA. vdasa@lsuhsc.edu.
authors.forename: Vinod
authors.initials: V
authors.lastname: Dasa
authors.affiliation: Department of Cell Biology and Anatomy, Louisiana State University, 1901 Perdido Street, Room 6123A, New Orleans, LA, 70112, USA. jmusse@lsuhsc.edu.
authors.forename: Jason
authors.initials: J
authors.lastname: Mussell
keywords: Anterior knee pain; Cryoneurolysis; Femoral cutaneous nerves; Infrapatellar nerves; Saphenous nerve