Oblique incisions in hamstring tendon harvesting reduce iatrogenic injuries to the infrapatellar branch of the saphenous nerve

Henry, Brandon Michael; Tomaszewski, Krzysztof A.; Pękala, Przemysław A.; Graves, Matthew J.; Pękala, Jakub R.; Sanna, Beatrice; Mizia, Ewa

doi:10.1007/s00167-017-4590-y

Cited by 21 publications

(36 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients after SN injury, the sensory function may return by 3 months, but full function will never be regained (Bai, ). Although nerve injuries commonly occur in orthopedic surgery, different approaches, such as cadaveric methods, have been examined to estimate risk before operating (Henry, ). In recent years, the utilization of USG has proven to be very effective in locating and visualizing even small nerves and identifying the risk of their injury (Pękala, ).…”

Section: Introductionmentioning

confidence: 99%

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

et al. 2018

Self Cite

View full text Add to dashboard Cite

When surgeons operate on the foot and ankle, the most common complication that may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the posterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. The study involved 40 healthy volunteers (n = 80 lower limbs). Ultrasound simulation of each potential surgical incision site was used to locate the SN and to assess the risk of injury. The study showed that the SN predominantly travels more posteriorly at levels more proximal from the tip of the lateral malleolus. At these more proximal points of the SN's course, it was proven that there was an overall increased incidence of iatrogenic injury to the SN in incisions made closer to the Achilles tendon. Based on these results, a quasi 3 dimensional figure was created showing the anatomical structures of this region to identify areas at high risk for SN injury. By revealing how length and position of the surgical incision can influence the risk of SN injury, we hope to provide information to surgeons on the optimal technique to avoid iatrogenic SN injury while operating on the distal tibia via a posterolateral approach. Clin. Anat. 31:870-877, 2018. © 2018 Wiley Periodicals, Inc.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ilio-tibial band pathology is present in 14% of repetitive trauma of the knee joint and occurs in cyclers, runners, joggers and skiers. Hamstrings disorders represents 3% of knee joint injuries, particularly among sprinters, jumpers, footballers; moreover hamstring tendons commonly serve as an autograft for a reconstructive surgery in the orthopedic field [24,31].…”

Section: Tendons In the Athletesmentioning

confidence: 99%

Tendon — function-related structure, simple healing process and mysterious ageing

Zabrzyński¹,

Łapaj

Paczesny³

et al. 2018

Folia Morphol

View full text Add to dashboard Cite

Tendons are connective tissue structures of paramount importance to human ability of locomotion. The understanding of their physiology and pathology is gaining importance as advances in regenerative medicine are being made today. So far, very few studies were conducted to extend the knowledge about pathology, healing response and management of tendon lesions.In this paper we summarize actual knowledge on structure, process of healing and ageing of the tendons. The structure of tendon is optimized for the best performance of the tissue. Despite the simplicity of the healing response, numerous studies showed, that the problems with full recovery are common and much more significant than we thought, that is why we discussed the issue of immobilization and mechanical stimulation during healing process. The phenomenon of tendons' ageing is poorly understood, although it seems to be a natural and painless process, it is completely different to degeneration in tendinopathy. Recent studies of biological treatment reported faster and optimal healing of the tendons when augmented by growth factors and stem cells. Despite advances in biology of tendons, management of their injuries is still a challenge for physicians, therefore further studies are required to improve treatment outcomes.

show abstract

“…Total knee arthroplasty is one of the most performed procedures in the world. However, this procedure, along with anterior cruciate ligament reconstruction, hamstring tendon harvest and medial meniscus surgery can often cause iatrogenic injury to the infrapatellar branch of the saphenous nerve (IPBSN), with rates ranging from 22.2 % to 69 % of patients (Koch et al, 2017;Ochiai et al, 2017;Henry et al, 2018). Furthermore, other procedures such as medial arthroscopic approaches and complementary posteromedial arthrotomies can cause injury to this nerve (Koch et al).…”

Section: Introductionmentioning

confidence: 99%

Anatomical Study of the Infrapatellar Branch of the Saphenous Nerve with Applications to Knee Surgery

et al. 2019

View full text Add to dashboard Cite

The infrapatellar branch of the saphenous nerve is a cutaneous nerve that innervates the area surrounding the patella and contributes to the peripatellar plexus. This nerve is target to iatrogenic injuries during a great deal of knee procedures, such as tendon harvesting, total knee arthroplasty and medial arthroscopic approaches to the knee. Lesion to this nerve can produce sensorial loss at its innervation territory. The study conducted herein aims to observe the anatomical aspects of the infrapatellar branch in cadaveric specimens. The infrapatellar branch of the saphenous nerve of 40 male cadavers was dissected with the purpose of identifying the number of branches, its relation with the patella, tibial tuberosity and sartorius muscle. The nerve was dissected and several measurements were performed with the aid of a digital caliper. Statistical analysis was performed with the MedCalc 16.1 software. The infrapatellar branch of the saphenous nerve was present in 100 % of the sample. Its mean distance from its origin to its branching point was 16.35±6.48 mm on the right and 21.94±4.31 mm on the left, with statistically significant differences (p < 0.05). A relatively safe zone for surgery was observed on the superior and medial aspect of the patella, which received less branches.

show abstract

Oblique incisions in hamstring tendon harvesting reduce iatrogenic injuries to the infrapatellar branch of the saphenous nerve

Cited by 21 publications

References 32 publications

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study

Tendon — function-related structure, simple healing process and mysterious ageing

Anatomical Study of the Infrapatellar Branch of the Saphenous Nerve with Applications to Knee Surgery

Contact Info

Product

Resources

About