Prevalence of Saphenous Nerve Injury After Autogenous Hamstring Harvest: An Anatomic and Clinical Study of Sartorial Branch Injury

Sanders, Brett; Rolf, Robert H.; McClelland, Walter B.; Xerogeanes, John W.

doi:10.1016/j.arthro.2007.03.099

Cited by 121 publications

(143 citation statements)

References 36 publications

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“…Peri-incisional dysesthesias after DAA THA may in fact be analogous to injury of the infrapatellar branch of the saphenous nerve (IPBSN) [29] in ACL reconstruction and TKA, in which numbness around the surgical wound is neither uncommon nor functionally impairing. Incidence ranges from 4% after TKA to up 88% after ACL reconstruction [1,11,34,40,45,52]. Similar to our findings, the clinical ramifications of an injury to the IPBSN, a cutaneous nerve, are few [1,52].…”

Section: Discussionsupporting

confidence: 88%

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Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

207

145

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 88%

“…Incidence ranges from 4% after TKA to up 88% after ACL reconstruction [1,11,34,40,45,52]. Similar to our findings, the clinical ramifications of an injury to the IPBSN, a cutaneous nerve, are few [1,52].…”

Section: Discussionsupporting

confidence: 88%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

207

145

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“…Iatrogenic saphenous nerve injury is a risk and has been previously described in the literature. 9 Careful dissection superficially and blunt dissection deep will help minimize this risk. Wound dehiscence can always be an issue with incisions in intertriginous locations.…”

Section: Surgical Techniquementioning

confidence: 99%

Minimally Invasive Posterior Hamstring Harvest

Wilson

Lubowitz

2013

Arthroscopy Techniques

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Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2-to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks.

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“…Thus, these can be considered to be good alternatives in reconstructing this ligament (19)(20)(21) . Sensory abnormalities during the postoperative period following ACL reconstruction, due to lesions of the infrapatellar branch of the saphenous nerve that are caused while harvesting graft material from the flexor tendon, may affect up to 74% of the patients (22) . Some studies have demonstrated that the incision used in harvesting the graft material may influence the frequency of these lesions (22,23) .…”

Section: Resultsmentioning

confidence: 99%

Lesão do ligamento cruzado anterior: tratamento e reabilitação. Perspectivas e tendências atuais

Arliani¹,

Astur²,

Kanas³

et al. 2012

Rev. bras. ortop.

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Objective: The aim of this study was to evaluate the procedures used by knee surgeons in Brazil for treating and rehabilitating anterior cruciate ligament injuries. Methods: A questionnaire consisting of 21 closed questions was developed, addressing topics relating to treatment and rehabilitation after anterior cruciate ligament reconstruction. The questionnaire was applied to Brazilian knee surgeons during the three days of the 42 nd Brazilian Congress of Orthopedics and Traumatology in 2010. Results: A total of 226 surgeons filled out the questionnaire completely. The most commonly used types of graft were hamstrings tendons and the central third of the ipsilateral patellar tendon, which were used by 82.3% and 53.5% of the sample, respectively. The technique of reconstruction with a single transtibial band was the first preference and was Rev Bras Ortop. 2012;47(2):191-96 used by 66.4% of the participants. A period of 1 to 4 weeks between injury and surgical procedure was considered ideal by most participants (52.65%). Complaints from patients that the knee was 'giving way' or unstable and presence of a positive pivot shift maneuver were the most decisive factors considered in making the decision to operate the patient. Patient satisfaction and absence of complaints of instability during the postoperative period were the criteria deemed to be most important for the surgery to be considered a success. Conclusions: There are clearly evolving trends in treating and rehabilitating the anterior cruciate ligament in Brazil. However, more prospective controlled studies are needed in order to evaluate the clinical and scientific benefits of these trends.

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Prevalence of Saphenous Nerve Injury After Autogenous Hamstring Harvest: An Anatomic and Clinical Study of Sartorial Branch Injury

Cited by 121 publications

References 36 publications

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Minimally Invasive Posterior Hamstring Harvest

Lesão do ligamento cruzado anterior: tratamento e reabilitação. Perspectivas e tendências atuais

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