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Summary
Reflex sympathetic dystrophy (RSD) of the knee is an extremely difficult problem to
treat. This study examined the possible relationship between isolated injury to the
infrapatellar branch of the saphenous nerve (IPBSN) and the etiology and natural course
of RSD. Thirty-five patients with clinically significant sympathetic dystrophy of
the knee were examined retrospectively. All patients (100%) had clinical evidence
of insult to the IPBSN. Thirty-three patients (94%) were found to have vasomotor instability
as measured by isolated cold stress testing (ICST). All patients in this population
of 33 were treated with vasoactive therapies. Subjective improvement was noted in
20 patients (p = NS). Initial ICSTs of improved and unimproved patients were compared.
Baseline temperatures were significantly warmer in patients who improved with therapy
(p < 0.05), and a warmer trend was evident throughout all phases of the test in those
who improved compared with those who did not. Eighty percent of patients treated within
1 year improved with one or more vasoactive therapies, whereas only 44 percent improved
when treatment was started after 1 year, indicating a significant population difference
(p < 0.05).
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© 1988 Arthroscopy Association of North America. All rights reserved. Published by Elsevier Inc.
