The saphenous nerve is the longest cutaneous branch of the femoral nerve, accompanying the femoral vessels through the adductor canal before emerging to supply sensation to the medial lower limb from knee to foot. As a purely sensory nerve its injury produces no weakness but significant medial lower limb dysaesthesia. It is the nerve most commonly damaged during knee surgery, particularly arthroscopy and medial meniscal procedures.
| Origin | Femoral nerve (L3, L4) |
|---|---|
| Course | Accompanies the femoral artery through the femoral triangle and adductor canal, exits medially at the adductor canal hiatus with the saphenous branch of the descending genicular artery, passes around the medial knee, and descends with the great saphenous vein to the medial ankle and foot |
| Motor |
|
| Sensory |
|
Saphenous nerve injury during knee arthroscopy usually affects the infrapatellar branch at the anteromedial portal, or the main nerve in posteromedial approaches, causing medial knee and leg numbness that distresses patients who were not warned. Lower down, the nerve runs with the great saphenous vein and is at risk during vein stripping or harvest at the ankle, medial ankle surgery and anteromedial ankle arthroscopy portals, sometimes leaving medial ankle burning from scar entrapment. Entrapment within the adductor canal (Hunter canal syndrome) causes medial knee and leg pain in cyclists and runners, reproduced by pressure over the canal and relieved by local anaesthetic. The nerve is blocked in the adductor canal for knee surgery and in front of the medial malleolus as part of an ankle block.
Iatrogenic damage during knee surgery, especially from anteromedial portal placement, produces medial leg and foot numbness without weakness.
Compression within Hunter canal produces medial knee and leg pain in cyclists and runners, managed with activity modification and nerve block injection.
Vein stripping, vein harvest or medial ankle surgery can injure or scar the nerve in front of the medial malleolus, causing medial ankle and foot numbness or burning pain that may need neurolysis.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
