Ultrasound-guided subsartorial plexus block: technical description, clinical correlation and cutaneous distribution mapping
DOI:
https://doi.org/10.65003/3htxj026Keywords:
Subsartorial plexus, Subsartorial space, Ultrasonography, Adductor canal, Knee analgesia.Abstract
The subsartorial plexus (SSP) constitutes a neural network formed by branches of the saphenous, obturator, and medial cutaneous femoral nerves. Located within the eponymous space—delimited by the sartorius muscle and the vastoadductor fascia—this anatomical structure plays a critical neuroanatomical role in the sensory innervation of the knee joint.
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References
1. Gardner E. The innervation of the knee joint. Anat Rec. 1948;101:109-30.
PMID: 18915634 DOI: 10.1002/ar.1091010111
2. Horner G, Dellon AL. Innervation of the human knee joint and implications for
surgery. Clin Orthop Relat Res. 1994;301:221–6. https://doi.org/10.1097/00003086-
199404000-0003
3. Tubbs RS, Loukas M, Shoja M, Apaydin N, Oakes W, Salter E G. Anatomy and
potential clinical significance of the vastoadductor membrane. Surg Radiol Anat.
2007;29:569-73. https://doi.org/10.1007/s00276-007-0230-4
4. Bendtsen TF, Moriggl B, Chan V, Pedersen EM, Borglum J. Redefining adductor canal
block. Reg Anesth Pain Med 2014;39:442-3 doi: 10.1097/AAP.0000000000000119.
5. Lecigne R, Dubreil PX,Berton E, Ropars M, Dalili D, Guillin R. Anatomic basis for
ultrasound-guided infiltration of the saphenous nerve in the subsartorial canal. J
Ultrasound 2022;25:429-34. https://doi.org/10.1007-021-00604-9
6. Bendtsen TF, Moriggl B, Chan V, Pedersen EM, Borglum J. The optimal analgesic block
for total knee arthroplasty. Reg Anesth Pain Med 2016;41:711-9. doi:
10.1097/AAP.0000000000000485.
7. Swenson JD, Davis J, Loose E. The Subsartorial Plexus Block A Variation on the
Adductor Canal Block. Reg Anesth Pain Med. 2015;40:732-33.
DOI: 10.1097/AAP.0000000000000319
8. Ly E, Joudi K, Ramanujam V Ultrasound Evaluation of Subsartorial Spread Following
Adductor Canal Block: A Case Series. Cureus 2024;16:e60849. https:// DOI.org/
10.7759/cureus.60849
9. Elazab E. Morphological study and relations of the fascia vasto-adductoria. Surg Radiol
Anat. 2017;39:1085-95. https://doi.org/10.10007/s00276-017-1846-7
10. Burckett-St Laurent D, Peng P, Giron Arango L, Niazi A, Chan V, Agur A, Perlas A.
The nerves of the Adductor Canal and the innervation of the knee. Reg Anesth Pain Med.
2016;41:321–7 DOI:10.1097/AAP.000000000000389
11. Woodworth GE, Arner A, Nelsen S, Nada E, Elkassabany NM. Pro and Con: How
important is the exact location of Adductor Canal and Femoral Triangle Blocks? Anesth
Analg. 2023;136:458-69. DOI 10.1213/ANE.0000000000006234
12. Fang Chiang Y, Wang MT, Chan SM, Chean ST, Wang ML, Hou JD, Tsai HC, Ling. JA.
Motor-Sparing Effect of Adductor Canal Block for Knee Analgesia.: An Update Review
and Subgroup Analysis of Randomized Controlled Trials based on a Correct
Classifications System. Healthcare 2023;11:210.
https://doi.org/10.3390/healthcare11020210
13. Andersen HL, Andersen SL, Tranum-Jensen J (2015) The spread of injectate during
saphenous nerve block at the adductor canal: a cadaver study. Acta Anaesthesiol Scand
2014;59:238–45. doi: 10.1111/aas.12451.
14. Wong WY, Bjørn S, Strid JM, Børglum J, Bendtsen TF. Defining the Location of the
adductor Canal Using Ultrasound Reg Anesth Pain Med 2017;42:241–5.
https://doi.org/10.1097/AAP.0000000000000539
15. Bjorn S, Nielsen T, Moriggl B, Hoermann R, Bendtsen T. Anesthesia of the anterior
femoral cutaneous nerves for total knee arthroplasty incision: randomized volunteer
trial. Reg Anesth Pain Med. 2020;45:107–16. https://doi.org/10.1136/rapm-2019-100904.
16. Sondekoppam RV, Johnston D, Ranganath Y, Parra M, Marian AA. Adductor canal or
femoral triangle block: the continuity conundrum. BJA 2020;124:e194-e195.
https://doi.org/10.1016/j.bja.2019.12.028
17. Tran J, Chan V, Peng P, Agur A. Evaluation of the proximal adductor canal block
injectate spread: a cadaveric study. Reg Anesth Pain Med. 2020;45:124–30.
https://doi.org/10.1136/rapm-2019-101091
18. Abdallah FJ, Prasad G, Moga R, Chahal J, Theodoropulus J, Dwyer T, Brull R. Opiod-
and Motor-sparing with Proximal, Mid and Distal Locations for Aductor Canal Block in
Anterior Cruciate Ligament Reconstruction. Anesthesiology 2019;131:619-629.
DOI: 10.1097/ALN.0000000000002817
19. Riegler G, Pivec C, Jengojan S, Mayer J, Schellen C,Tratting S, Bodner G. Cutaneous
nerve fields of the anteromedial lower limb-Determination with selective ultrasound-
guided nerve blockade. Clin Anat. 2021;34:11-8 DOI: 10.1002/ca.23582
20. Kampitak W, Tanavalee A, Tansatit T, Ngarmukos S, Songborassamee N, Vichainarong
C. The analgesic efficacy of anterior femoral cutaneous nerve block in combination with
femoral triangle block in total knee arthroplasty: a randomized controlled trial. Korean J
Anesthesiol. 2021;74:496-505 https//doi.org/10.4097/kja.21120
21. Yeoh S-R, Chang WC, Wang KL, Tai KY, Hsu FK, Chuang CW. Suprasartorial
subcutaneous infiltration (SSSI)for anterior femoral cutaneous nerve coverage in total
knee arthroplasty: A preliminary clinical study. Biomedicine 2025;13:2368.
http//doi.org/10.3390/biomedicines13102368
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Copyright (c) 2026 Carlos Bollini, Aixa Pitté Fletcher, Gustavo Carradori, Miguel A. Reina (Autor/a)

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