Genicular Nerves

Description

Innervation of the knee. The origin of the superomedial and superolateral genicular nerves (from the sciatic nerve or from the femoral nerve) is controversial

Schematic diagram showing posterior (A) and anterior (B) innervation of the knee capsule and joint. The three genicular targets are the SMGN, SLGN and IMGN. ILGN, inferolateral genicular nerve; IMGN, inferomedial genicular nerve; NVI, nerve to vastus intermedius; NVL, nerve to vastus lateralis; NVM, nerve to vastus medialis; RPN, recurrent peroneal nerve; SaN, saphenous nerve; SLGN, superolateral genicular nerve; SMGN, superomedial genicular nerve.

Names

• Genicular Nerves
• Geniculate Nerves

Introduction

• Knee innervation is complex
• They are branches from femoral nerve, obturator nerve, sciatic nerve
• Significant anatomic variability creates some confusion in the literature
• To understand innervation, divide the knee into anterior and posterior compartments
  • Anterior compartment can be divided into four quadrants which correspond to the 4 geniculate nerves

Superolateral Geniculate Nerve

• Courses around the femur shaft to pass between the vastus lateralis, lateral femoral condyle
• It accompanies the superior lateral genicular artery

Superomedial Geniculate Nerve

• Courses around the femur shaft, following the superior medial genicular artery
• Passes between the adductor magnus tendon and medial femoral condyle below the vastus medialis

Inferolateral Geniculate Nerve

• Courses around the lateral tibial plateau deep to the lateral collateral ligament
• It follows the inferior lateral genicular artery, superior of the fibula head

Inferomedial Geniculate Nerve

• Courses horizontally below the medial collateral ligament
• Between the medial tibial plateau and the insertion of the MCL
• It accompanies the inferior medial genicular artery

Recurrent Peroneal Nerve

• Originates in the inferior popliteal region from the common peroneal nerve
• Courses horizontally around the fibula to pass just inferior of the fibula head
• Travels superior to the anterolateral tibial plateau
• It accompanies the recurrent tibial artery

Anatomic Variants

• Some cadaver studies show contributions from
  • Recurrent peroneal nerve
  • Nerve to the vastus medialis
  • Nerve to the vastus intermediate
  • Nerve to the vastus lateralis
  • Infrapatellar branch

---

Clinical Significance

• Geniculate Nerve Injection
• Geniculate Nerve Block

---

See Also

• Knee Pain Main
• Knee Anatomy Main
• Procedures Main

---