The saphenous nerve, a branch of the femoral nerve, is at particular risk during which common surgical procedure because of its anatomical course in the subsartorial (Hunter's) canal?

• A Total knee replacement via medial parapatellar approach
• B Anterior cruciate ligament reconstruction using patellar tendon graft
• C Medial meniscectomy via posteromedial approach
• D Long saphenous vein (great saphenous vein) stripping for varicose veins ✓

Explanation

The saphenous nerve exits the subsartorial (adductor/Hunter's) canal alongside the great saphenous vein in the distal thigh and descends with the vein down the medial leg to the medial malleolus. During stripping of the great saphenous vein for varicose vein surgery, the saphenous nerve is at high risk of injury, causing medial leg and foot paresthesia/numbness. This is the most common neurological complication of varicose vein surgery. Knee replacement and ligament reconstruction do not primarily threaten the saphenous nerve along the thigh, though the infrapatellar branch may be cut in knee incisions.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.