Injury to the infrapatellar branch of the saphenous nerve (IPBSN), is known to cause regional hypoesthesia of the lower leg after anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine if the orientation of the graft harvest incision does influence the prevalence of postoperative hypoesthesia. Furthermore, to describe change, if any, of the hypoesthetic area, during the first postoperative year. Our hypothesis was that an oblique incision parallel to the nerve branch would reduce the incidence of this complication and the area with hypoesthesia after ACL reconstruction, compared to the vertical incision. Secondly, that the area with hypoesthesia is reduced over time. Fifty patients underwent a primary ACL reconstruction using hamstring graft. Twenty-five patients were operated using a vertical incision for graft harvest, and 25 were operated using a slightly oblique incision. Twelve days after surgery and at a one year follow-up the patients had their sensibility of the lower leg examined. We found that hypoesthesia is a common complication (88 %) after hamstring ACL surgery. Change from vertical to slightly oblique incision did not reduce the morbidity. Furthermore, the area with sensory loss, felt by the patient shortly after surgery, was shown to decrease significantly by 46.3 percent after one year.
2
Bertram C, Porsch M, Hackenbroch M H, Terhaag D.
Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft.
Arthroscopy.
2000;
16
763-766
4
Boon J M, Van Wyk M J, Jordaan D.
A safe area and angle for harvesting autogenous tendons for anterior cruciate ligament reconstruction.
Surg Radiol Anat.
2004;
26
167-171
6
Kartus J, Ejerhed L, Eriksson B I, Karlsson J.
The localization of the infrapatellar nerves in the anterior knee region with special emphasis on central third patellar tendon harvest: a dissection study on cadaver and amputated specimens.
Arthroscopy.
1999;
15
577-586
7
Kartus J, Magnusson L, Stener S, Brandsson S, Eriksson B I, Karlsson J.
Complications following arthroscopic anterior cruciate ligament reconstruction. A 2 - 5-year follow-up of 604 patients with special emphasis on anterior knee pain.
Knee Surg Sports Traumatol Arthrosc.
1999;
7
2-8
10
Pagnani M J, Warner J J, O'Brien S J, Warren R F.
Anatomic considerations in harvesting the semitendinosus and gracilis tendons and a technique of harvest.
Am J Sports Med.
1993;
21
565-571
11
Papastergiou S G, Voulgaropoulos H, Mikalef P, Ziogas E, Pappis G, Giannakopoulos I.
Injuries to the infrapatellar branch(es) of the saphenous nerve in anterior cruciate ligament reconstruction with four-strand hamstring tendon autograft: vertical versus horizontal incision for harvest.
Knee Surg Sports Traumatol Arthrosc.
2006;
14
789-793
12
Passler J M, Schippinger G, Schweighofer F, Fellinger M, Seibert F J.
[Complications in 283 cruciate ligament replacement operations with free patellar tendon transplantation. Modification by surgical technique and surgery timing].
Unfallchirurgie.
1995;
21
240-246
13
Portland G H, Martin D, Keene G, Menz T.
Injury to the infrapatellar branch of the saphenous nerve in anterior cruciate ligament reconstruction: comparison of horizontal versus vertical harvest site incisions.
Arthroscopy.
2005;
21
281-285
14
Spicer D D, Blagg S E, Unwin A J, Allum R L.
Anterior knee symptoms after four-strand hamstring tendon anterior cruciate ligament reconstruction.
Knee Surg Sports Traumatol Arthrosc.
2000;
8
286-289
