Injury to the Infrapatellar Branch of the Saphenous Nerve during ACL Reconstruction with Hamstring Tendon Autograft: A Comparison between Oblique and Vertical Incisions

Abstract

Background: Injury to the infrapatellar branch of the saphenous nerve (IPBSN) is common after arthroscopic ACL<br />reconstruction with hamstring tendon autograft, as reported in up to 88% of the cases. Due to close relationship<br />between the IPBSN with pes anserine tendons insertion skin incision may sever IPBSN while harvesting gracillis and<br />semitendinous tendons. As the IPBSN course at the anterior of knee is oblique, we hypothesized a parallel skin incision<br />with nerve passage may decrease nerve injury.<br />Methods: Vertical and oblique incisions were compared in 79 patients in this clinical trial. The sensory loss area and<br />patients' complain of numbness were measured at 2 and 8 weeks as well as 6 months after surgery.<br />Results: Both the sensory loss area and patients' complain of numbness decreased significantly in the oblique incision<br />group (P<0001).<br />Conclusion: According to our findings, oblique incision is suggested instead of traditional vertical incision when<br />hamstring tendons are being harvested in arthroscopic ACL reconstruction with hamstring tendon autograft.<br />Level of evidence: IV