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

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

کلیدواژه ها:

ACL reconstruction ، Hamstring graft harvest ، Infrapatellar branch of saphenous nerve ، Nerve injury ، Saphenous nerve