A Basic Research Of A Highly Selectivenerve Cutting Or Block Treatment For Pain Of Osteoarthritis

Objectives: Osteoarthritis (OA)is the common joint disease in the elderly, involving the knee joint as the one of the most vulnerable, currently there are still no treatment method which can effectively block the pathological process, the main goals of treatment are to relieve the pain and improve functionality of the joint itself. In order to reduce the pain in patients with knee Osteoarthritis, slow down the progress rate of the disease, we design a new experimental treatment: Highly selective nerve branch cut or block the pain of the knee in OA. This topic is mainly based on the anatomical study of the nerve branch on the knee joint, to provide an anatomical basis for the highly selective nerve branch cut or block treatment.Methods: Part I: anatomically observe the distribution of nerve branch of the knee joint of 10 out of 20 specimens of the lower limb, describe and measure the nerve shape, distribution of surface projection and the distance relation between the bone marking, draw the structure of the anatomical position of nerves in the knee joint; Part II: In fresh specimens and knee specimens from the amputated limb, harvest a fresh nerve branch from the amputated knee, histochemically stained with acetyl cholinesterase, identify the natural characteristics of the nerve branch, namely movement branch, sensory, or mixed branch. Results:1.The knee joint nerve branch can be divided into superficial and deep two-layerThe superficial Layer nerve branch are mainly consist of: lateral femoral cutaneous nerve, medial cutaneous nerve of thigh, intermediate cutaneous nerve of thigh, patellar branch and infrapatellar branch of saphenous nerve, posterior femoral cutaneous nerve;The deep layer nerve branch are mainly consists of: branch to knee joint of vastus medialis muscle nerve, branch to knee joint of vastus medialis muscle nerve in muscle, branch to knee joint of intermediate unit muscle nerve, branch to knee joint of vastus lateralis muscle nerve, branch to knee joint of vastus lateralis muscle nerve in muscle, medial branch to knee joint of sciatic nerve, lateral branch to knee joint of sciatic nerve, tibial nerve branches of the popliteal fossa and below the knee joint, lateral branch to knee joint of tibial nerve, branch to knee joint of common peroneal nerve, return branch to knee joint of common peroneal nerve. The distribution of each nerve branch has small common region with its neighbors in the knee joint, but each nerve branch of knee joint has its own relatively fixed level and dominate region.2. Characteristics of the nerve branch in the knee joint Sensory branch: lateral femoral cutaneous nerve, medial cutaneous nerve of thigh, intermediate cutaneous nerve of thigh, posterior femoral cutaneous nerve. Movement branch: branch to knee joint of vastus medialis muscle nerve, branch to knee joint of vastus medialis nerve in muscle, branch to knee joint of intermediate unit muscle nerve, branch to knee joint of vastus lateralis nerve, branch to knee joint of vastus lateralis nerve in muscle, medial branch to knee joint of sciatic nerve, lateral branch to knee joint of sciatic nerve, sciatic nerve branches of the popliteal fossa and below the knee joint, Lateral branch to knee joint of tibial nerve, branch to knee joint of common peroneal nerve, return branch to knee joint of common peroneal nerve.Mixed branch: patellar branch and infrapatellar branch of saphenous nerve.Conclusion:1. Distribution of nerve branch of the knee joint have a relatively fixed layer and allocated region.2. The knee pain radiating in patients with OA of the knee joint originates from the deep layer movement nerve branch of the knee joint.