The infrapatellar plexus is formed by terminal branches of the saphenous infrapatellar branch, the medial retinacular nerves, and the lateral retinacular nerve, creating an anastomotic network supplying the patellar tendon, inferior patella, Hoffa's fat pad, and anterior tibial plateau. It is the most complex sensory nerve network in the anterior knee.
The infrapatellar plexus is damaged during knee replacement surgery and anterior knee approaches, contributing to infrapatellar numbness (lateral to the tibial crest) and the painful neuroma formation that accounts for up to 25% of anterior knee pain after total knee arthroplasty. Selective infrapatellar branch neurectomy and neurolysis are performed for post-TKA anterior knee pain. Saphenous nerve preservation during medial approaches protects the infrapatellar contribution.
Traumatic neuroma formation in the infrapatellar plexus following total knee arthroplasty, producing anterior knee hyperalgesia and allodynia, managed by neuroma excision or targeted desensitisation.
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