WAY OF CHOOSING A METHOD OF TREATMENT OF COMPRESSION-ISCHEMIC NEUROPATHY OF THE SUBPATELLAR BRANCH OF THE SAPHENOUS NERVE OF THE THIGH (SBSNT) IN PATIENTS WITH GONARTHROSIS Russian patent published in 2023 - IPC A61B8/08 

FIELD: medicine; neurology; anesthesiology.

SUBSTANCE: invention can be used in traumatology and orthopedics for the diagnosis and treatment of pain in the anterior-medial section of the knee joint with gonarthrosis. Scanning is performed at the level of the anterior-medial parts of the knee joint in the area of the medial femoral condyle and joint space in the longitudinal plane in the craniocaudal direction, placing the patient in the supine position, and the linear ultrasonic transducer in the longitudinal plane in the projection of the joint space. An image is verified that contains the medial contours of the condyles of the femur and tibia with marginal exostoses, as well as the contour of the prolapsed internal lateral ligament (ILL) and the contour of the prolapsed fascia lata of the thigh, which is the lower border of the interfascial space in which the subpatellar branch of the saphenous nerve of the thigh (SBSNT) is located. On the obtained image on the monitor screen of the ultrasonic scanner in the freeze frame mode, a straight line is drawn through the points of the proximal and distal attachment sites of the IBP to the femoral condyle (FC) with exostosis and the tibial condyle (TC). The value of the prolapse of the VBS is determined, which is equal to the distance from this line to the point on the prolapsed VBS, as far as possible from this line. With a prolapse value over 10.0 mm, a conclusion is made about the presence of compressive-ischemic neuropathy (CIN) and an interventional method of treatment is chosen. Additionally, an ultrasonic transducer is placed in the transverse plane in the supracondylar zone of the LBC, visualizing the initial section of the SBSNT outside the zone of compression in the interfascial space (OZCIFS). By displacing the ultrasound transducer in the distal direction to the level of the joint space, at the level of prolapse of the IBP on the verified image, the amount of narrowing of the interfascial space in which the SBSNT is located is recorded as the distance from the point of the contour of the wide fascia of the thigh, which is the lower point on the boundary line of the interfascial space, to the point the contour of the border of the superficial fascia, which is the uppermost point on this contour, and, if this distance is less than 0.8 mm, it is evaluated as an additional factor indicating the presence of CIN, and an interventional method of treatment is chosen.

EFFECT: method provides increasing the reliability of verification and information content of ultrasound by identifying ultrasonic parameters and the size of pathologically altered periarticular tissues that cause compressive neuropathy of SBSNT, on the basis of which a choice of treatment method is subsequently made.

2 cl, 3 dwg, 1 tbl, 3 ex