Genicular Nerve Block
An Overview of the Deep and Superficial Nerves which Innervate the Knee
Basic Anatomy
The innervation of the knee joint is complex and involves several nerves that provide both sensory and motor functions. Key nerves involved in the innervation of the knee include:
1. Femoral Nerve : This major nerve innervates the anterior compartment of the thigh and provides sensory innervation to the skin over the anterior thigh and the medial side of the leg. It gives rise to several branches, including:
Saphenous Nerve : This branch provides sensory innervation to the medial aspect of the knee and the skin on the medial side of the leg.
Nerve to Vastus Lateralis: This branch innervates the vastus lateralis muscle, which is part of the quadriceps group and plays a role in knee extension.
Anterior femoral cutaneous nerves: Which divide and run superficial to the musculature above the knee
2. Sciatic Nerve: The sciatic nerve branches into two main nerves:
Tibial Nerve: This nerve runs posterior to the knee and innervates the muscles in the posterior compartment of the leg. It provides sensory innervation to the posterior aspect of the knee joint through its branches, including the **medial sural cutaneous nerve**.
Common Peroneal Nerve: This nerve innervates the lateral and anterior compartments of the leg. It gives off the **lateral sural cutaneous nerve**, which supplies sensation to the lateral aspect of the leg. The common peroneal nerve further divides into:
Superficial Peroneal Nerve: Innervates the lateral compartment of the leg and provides sensory innervation to the dorsum of the foot.
Deep Peroneal Nerve: Innervates the anterior compartment of the leg and provides sensory innervation to the web space between the first and second toes.
3. Obturator Nerve: This nerve primarily innervates the adductor muscles of the thigh. It also contributes sensory fibers to the knee joint, particularly the medial aspect.
4. Genicular Nerves: These are branches that specifically innervate the knee joint and include:
Superomedial Genicular Nerve: A branch of the femoral nerve.
Superolateral Genicular Nerve: A branch of the common peroneal nerve.
Inferomedial Genicular Nerve: A branch of the tibial nerve.
Inferolateral Genicular Nerve: A branch of the common peroneal nerve.
5. Accessory Fibular Nerve : This nerve, also known as the **fibular communicating branch**, can arise from the common peroneal nerve and provides additional sensory innervation to the lateral aspect of the knee joint.
The sensory innervation provided by these nerves is crucial for proprioception, pain sensation, and the overall functionality of the knee joint. This intricate network of nerves allows for coordinated movement and response to stimuli, which is essential for activities such as walking, running, and jumping.
Alleviating Knee Pain
Online and In Person Workshops
Infrapatellar Saphenous and Anterior Femoral Cutaneous Nerve Blocks
Going Beyond the 3 Deep Genicular Nerves