Clinical and electrophysiological assessment of injury to infrapatellar branch(es) of saphenous nerve during anterior cruciate ligament reconstruction using oblique incision for hamstring graft harvest: A prospective study |
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| Institution: | 1. Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.;2. Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan;3. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany;1. Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;2. Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan;3. Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;4. Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan;5. The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan;6. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan;7. Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;8. Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;9. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;10. School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan;1. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.;2. Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A. |
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| Abstract: | BackgroundOne of the complications of arthroscopic reconstruction of anterior cruciate ligament (ACL) using hamstring autograft is injury to the infrapatellar branch of the saphenous nerve (IPBSN) leading to loss of sensation around the knee. Its incidence varies according to the orientation of incision for hamstring graft harvest, with oblique incision having the lowest chance of this injury. Aim of this study was to assess clinically and electrophysiologically injury to IPBSN after ACL reconstruction using oblique incision for hamstring graft harvest.MethodsFifty patients that were scheduled to undergo arthroscopic ACL reconstruction were included. All the patients were evaluated both clinically and electrophysiologically preoperatively and at three weeks and six months postoperatively to determine injury to IPBSN. Patient satisfaction after surgery was also compared.ResultsIPBSN injury was found to be present in 12 out of 50 patients (24%). Both clinical and electrophysiological data correlated completely. The difference in the length of the skin incisions between IPBSN injured and IPBSN intact patients was found to be statistically significant (P = .0043). The difference in the satisfaction score between patients with injured and intact IPBSN was also found to be statistically significant (P = .02).ConclusionsOblique incision for hamstring graft harvest results in lower incidence of IPBSN injury and subsequent sensory loss when compared with similar studies with different skin incisions carried out in the past. Patients undergoing ACL reconstruction should be counseled preoperatively regarding this potential complication, and if this complication occurs, improvement can be expected with time. |
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