Nerve injury during hamstring graft harvest: a prospective comparative study of three different incisions

Abstract

Therapeutic randomized controlled prospective study, level I.

Graft Harvest and Preparation

“…These branches originate from the saphenous nerve (IPSBN: infrapatellar branch of saphenous nerve) and medial femoral cutaneous nerve (SBSN: sartorial branch of sensory nerve) [ 20 , 24 ]. While an oblique incision has less incidence of IPSBN transections, injury to SBSN is not affected by the type of incision used [ 27 ]. In any case, and in agreement with our own observations, it has been concluded that daily living is nothing or only slightly affected by these sensory changes [ 21 ].…”

Risk of iatrogenic injury to the infrapatellar branch of the saphenous nerve during hamstring tendon harvesting: A meta‐analysis

“…The characteristics of the studies included in the meta‐analysis are summarized in Table . Eleven studies ( n = 1,050 patients) reported such . The postoperative follow‐up time for patients in the studies ranged from 6–78 months.…”

“…Two studies ( n = 305 patients) directly compared the rate of iatrogenic IPBSN injury during the procedure with vertical versus horizontal incisions. Similarly, 4 studies ( n = 245 patients) directly compared the rate of such injury with vertical versus oblique incision orientations.…”

“…The saphenous nerve is the longest cutaneous branch of the femoral nerve. It divides into the infrapatellar branch and the sartorial branch of the nerve, which runs along the great saphenous vein to the medial side of the foot . The infrapatellar branch of the saphenous nerve (IPBSN) diverges from the main saphenous nerve at the level of the knee joint, courses around the posterior border of the sartorius muscle, pierces the fascia lata, and travels straight to supply the skin over the medial side and front of the knee and the patellar ligament (Fig.…”

Relationship between peri-incisional dysesthesia and the vertical and oblique incisions on the hamstrings harvest in anterior cruciate ligament reconstruction

“…This may not represent the actual rate of dysesthesia found in these patients, taking into account the possibility of neurological recovery that can occur in the first two years after surgery 16 . Furthermore, the functional impact in patients with neurological deficit was not measured and, finally, this study did not assess the possible involvement of the saphenous nerve due to the use of a stripper to collect graft, which could perhaps explain the lower rate of dysesthesia, albeit still present, found in the group in which the oblique incision was used 17, 18…”