EFFECT OF SAPHENOUS NERVE RELEASE ON PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

NCT ID: NCT07318987

Last Updated: 2026-01-06

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 36 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-10-10
• Study Completion Date: 2026-01-27

Brief Summary

Patellofemoral Pain Syndrome (PFPS) is a frequent cause of anterior knee pain in young, physically active individuals, especially females, and is commonly managed with quadriceps and hip-focused exercises. However, the role of neural factors has been largely overlooked. The saphenous nerve, which supplies sensation to the anteromedial knee, may become irritated or entrapped and contribute to pain and neuromuscular dysfunction in PFPS. This study suggests that manual therapy targeting the saphenous nerve could improve pain, function, and balance, providing a more holistic approach to PFPS rehabilitation.

Detailed Description

Patellofemoral Pain Syndrome (PFPS) is a common cause of anterior knee pain, particularly affecting adolescents and young adults, with a higher prevalence among females. It accounts for a significant proportion of knee complaints seen in sports medicine and is especially common in physically active individuals. Traditional rehabilitation for PFPS has mainly focused on quadriceps strengthening and knee mechanics, with more recent attention given to hip-focused exercises.

However, the neural contribution to PFPS, particularly involving the saphenous nerve and its infrapatellar branch, has been relatively under-explored. The saphenous nerve is a purely sensory branch of the femoral nerve that supplies the anteromedial knee and lower leg and plays an important role in proprioception. Anatomical variations and its course near the sartorius muscle may predispose it to irritation or entrapment, potentially contributing to chronic anteromedial knee pain.

This study proposes that irritation or mechanosensitivity of the saphenous nerve may be a contributing factor in PFPS, leading to pain and impaired neuromuscular control. By incorporating manual therapy targeting the saphenous nerve, the research aims to fill a gap in current PFPS management. Addressing neural factors may enhance pain reduction, functional performance, and balance, offering a more comprehensive and holistic physiotherapy approach for individuals with PFPS. (summarize in short)

Conditions

Patellofemoral Pain Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

SAPHENOUS NERVE RELEASE

The patient is in a supine position with the leg extended. Look for a sensitive area four to five fingerbreadths above the knee on the medial side. This will be a long strip of fascia that is several inches in length. The fingers are then placed on either side of this strip on the medial side of the leg behind the sartorius muscle. The fingers are pulled apart in distal and proximal directions, as if to separate the strip as far as possible

Group Type: EXPERIMENTAL

Saphenous nerve release

Intervention Type: OTHER

With the patient lying supine and the leg extended, a tender area is identified on the medial side of the thigh, approximately four to five fingerbreadths above the knee. This area corresponds to a longitudinal fascial strip located behind the sartorius muscle. The therapist places the fingers on either side of this strip and applies a gentle separating force in proximal and distal directions to mobilize the tissue and reduce sensitivity.

traditional treatment

The intervention program lasted six weeks and was performed three times per week. It included strengthening, manual therapy, and stretching exercises. Strengthening focused on both the hip and knee. Hip exercises consisted of side-lying hip abduction, clamshells, and prone hip extension, while knee exercises included straight leg raises, terminal knee extensions, and wall-supported mini-squats. Exercises progressed from 3 sets of 10 to 3 sets of 20 repetitions, with gradual resistance added, dynamic execution, brief pauses between repetitions, and short rest periods between sets.

Manual therapy involved patellofemoral joint mobilization performed in a supine position with the knee slightly flexed, using superior, inferior, medial, and lateral patellar glides.

Stretching exercises were performed in sitting or standing, targeting the posterior structures with the knee extended and ankle dorsiflexed. Static stretches were held for 15 seconds and repeated for three sets.

Group Type: ACTIVE_COMPARATOR

Saphenous nerve release

Intervention Type: OTHER

With the patient lying supine and the leg extended, a tender area is identified on the medial side of the thigh, approximately four to five fingerbreadths above the knee. This area corresponds to a longitudinal fascial strip located behind the sartorius muscle. The therapist places the fingers on either side of this strip and applies a gentle separating force in proximal and distal directions to mobilize the tissue and reduce sensitivity.

Interventions

Saphenous nerve release

With the patient lying supine and the leg extended, a tender area is identified on the medial side of the thigh, approximately four to five fingerbreadths above the knee. This area corresponds to a longitudinal fascial strip located behind the sartorius muscle. The therapist places the fingers on either side of this strip and applies a gentle separating force in proximal and distal directions to mobilize the tissue and reduce sensitivity.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1 - Age from 18 to 35 and BMI 18 to 25 kg/m2. 2. Both gender (male and female) 3. Patients who had anterior knee pain for at least six weeks 4. Patients with positive saphenous neurodynamic test (SAPHNT)

Exclusion Criteria

1. Knee replacement

2. An intraarticular injection within the past 3 months

3. Previous operative treatment or arthroscopy, other secondary knee-related problems (bursitis, tendinopathy, osteochondritis, neuromas, intraarticular pathology (such as osteoarthritis), tumor, and rheumatologic diseases

4. Diabetic neuropathic pain or fibromyalgia

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Markos Boshra Agaiby Amin

Teaching assistant

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Faculty of Physical Therapy, Cairo University

Cairo, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Markos Boshra, bachelor's

Role: CONTACT

markosboshra3@gmail.com

01201365245

Markos Boshra, bachelor's

Role: CONTACT

markosboshra3@gmail.com

01550799147

Other Identifiers

P.T.REC/012/006114

Identifier Type: -

Identifier Source: org_study_id