Key Finding
Acupotomy combined with ultrasound-guided perineural injection immediately reduced severe nerve entrapment pain from 10/10 to 1/10 on the VAS scale and restored normal function in a patient with IBSN compression following ACL reconstruction.
Researchers reported on a case involving a 14-year-old male who experienced severe nerve pain following anterior cruciate ligament (ACL) reconstruction surgery. After the initial surgery healed successfully, the patient developed intense pain two weeks after a mild strain, caused by compression of a small nerve called the infrapatellar branch of the saphenous nerve (IBSN) near the knee. This nerve entrapment is a known complication of ACL surgery.
The medical team first tried ultrasound-guided nerve block injections using lidocaine, a local anesthetic. While this provided some temporary relief, the pain quickly returned. They then performed acupotomy, a traditional Chinese medicine technique that uses a specialized small needle knife to release adhesions and entrapped tissues around nerves.
The results were dramatic and immediate. The patient's pain level dropped from 10 out of 10 to just 1 out of 10 on the visual analog scale right after the acupotomy treatment. He was able to return to normal walking immediately. Follow-up ultrasound imaging showed that the swollen nerve returned to a more normal size and the surrounding tissue inflammation decreased significantly.
This case suggests that acupotomy combined with guided injection may offer an effective treatment option for patients experiencing nerve entrapment pain after knee surgery, particularly when standard treatments provide only temporary relief. The benefits appeared to last longer than injection therapy alone. If you're experiencing persistent nerve pain after knee surgery, consult with a qualified acupuncture practitioner experienced in advanced techniques like acupotomy.
This case report describes successful treatment of infrapatellar branch of saphenous nerve (IBSN) entrapment following ACL reconstruction in a 14-year-old male patient. Initial intervention consisted of ultrasound-guided perineural injection with 0.4% lidocaine, which provided only temporary, partial symptom relief. Subsequent acupotomy using a 0.4x40mm small needle knife resulted in immediate resolution of severe pain. Objective measures showed VAS reduction from 10/10 to 1/10, with immediate restoration of normal gait. Ultrasound imaging post-treatment demonstrated decreased IBSN diameter and hypoechoic changes in perinevral soft tissue, indicating reduced inflammation and edema. The mechanism of action involves mechanical release of adhesions and entrapped nerve tissue. This combined approach—ultrasound-guided injection followed by acupotomy—appears to provide superior and longer-lasting therapeutic effects compared to injection alone for post-surgical nerve entrapment complications. Clinical takeaway: Acupotomy may serve as an effective adjunct treatment for refractory peripheral nerve entrapment when conventional interventions fail.
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