METHOD OF TREATING COMPRESSION-ISCHEMIC NEUROPATHY OF INFRAPATELLAR BRANCH OF SAPHENOUS NERVE OF FEMUR IN PATIENTS WITH PAIN SYNDROME OF MEDIAL PARTS OF KNEE JOINT WITH GONARTHROSIS WITH ULTRASOUND-ASSISTED HYDRODISSECTION Russian patent published in 2024 - IPC A61M19/00 A61M5/32 A61B8/08 A61K31/573 A61K31/167 A61P19/02 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to anaesthesiology, can be used for the treatment of compression-ischemic neuropathy of the infrapatellar branch of the saphenous nerve of the femur (IBSNF) in patients with pain syndrome of medial parts of knee joint with gonarthrosis with ultrasound-assisted hydrodissection by introduction of therapeutic mixture containing corticosteroid, into the interfacial space with an infrapatellar branch of the saphenous nerve of the femur. Hydrodissection is carried out in the interfacial compressed space, preliminarily determining the place of maximum compression of the infrapatellar branch of the saphenous nerve of the femur, by means of ultrasonic scanning of soft tissues in the knee area at the level of the anteromedial parts of the knee joint in the area of the medial femoral condyle and the joint space in the longitudinal plane in the craniocaudal direction, placing the patient in a supine position. Linear ultrasonic sensor is placed in the longitudinal plane in the projection of the joint space, verifying the anatomical course of the nerve trunk, its structure, clearness of contours, as well as condition of surrounding tissues, analysing parameters of structures surrounding nerve. Image containing medial contours of condyles of femur and tibia with marginal exostoses is verified, as well as the contour of the prolapse internal lateral ligament (ILL) and the contour of the prolapse fascia lata, which is the lower boundary of the interfascial space, in which the IBSNF is located, at that, on the obtained ultrasound image on the monitor of the ultrasound scanner in the freeze frame mode, a straight line is drawn through the points of the proximal point and the point of distal attachment of the ILL to the femoral condyle (FC) with exostosis and the tibial condyle (TC). Value of the prolapse of the ILL is determined, which is equal to the distance from this line to the point on the prolapsed ILL, which is as distant as possible from this line. Hydrodissection is carried out with a prolapse value of more than 10.0 mm, wherein the ultrasonic sensor in the longitudinal plane at the level of the anterior-medial portion of the knee joint and fixing the image of the prolapsed ILL and the area of maximum interfascial space (IS) narrowing on the monitor screen. Needle is pricked under the patient's skin in the plane of the sensor at angle of 35-40 degrees to this plane, moving it in the cranial direction and penetrating the needle tip subcutaneously. Therapeutic mixture containing a corticosteroid in the form of a solution of diprospan 2 ml with ropivacaine hydrochloride 20 mg in a total volume of 22 ml is introduced into the area of maximum narrowing of the interfascial space, in which the compressed IBSNF is located.

EFFECT: method provides more effective analgesic action with a longer painless period in the medial region of the knee joint by determining the point of needle sticking.

1 cl, 2 dwg, 1 tbl, 3 ex