Saphenous nerve injury during hamstring tendons harvest: Does the incision matter? A systematic review

Ruffilli, Alberto; Fine, Marcello De; Traina, Francesco; Pilla, Francesco; Fenga, Domenico; Faldini, Cesare

doi:10.1007/s00167-016-4217-8

Cited by 47 publications

(44 citation statements)

References 24 publications

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“…Three main incisional approaches are currently used—horizontal, vertical, and oblique. The choice of one over the other has been a subject of contention among surgeons, since each carries its own specific benefits and risks (Ruffilli et al, ; Pękala et al, ). The goal of the present study was to use high‐resolution USG to locate the IPBSN and estimate the rate of injury for each of the three main incision types.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, we attempted to assess the risk of injury to the IPBSN in relation to the nerve's pattern of emergence. Recent systematic studies (Ruffilli et al, 2016;Pe R kala et al, 2017) have comprehensively reviewed the literature concerning iatrogenic injury to the IPBSN during hamstring tendon harvesting, seeking the safest incision type. Despite numerous publications on this topic, the study quality assessments by the authors of the two above-mentioned systematic reviews (Ruffilli et al, 2016;Pe R kala et al, 2017) concluded that most of the existing clinical studies can be described as methodologically poor or medium, so there is a need for new well-designed clinical trials and translational research.…”

Section: Discussionmentioning

confidence: 99%

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Injury to the infrapatellar branch of the saphenous nerve during tendon graft harvesting for knee ligament reconstruction: An ultrasound simulation study

Pękala¹,

Miza

Henry³

et al. 2017

Clinical Anatomy

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The clinical anatomy of the infrapatellar branch of the saphenous nerve (IPBSN) is of particular importance during operations in the area of the knee, especially when material for anterior cruciate ligament reconstruction is harvested. The nerve can easily be injured during the harvesting procedure, leading to postoperative complications that reduce quality of life. Three different skin incisions are commonly used during hamstring tendon harvesting: horizontal, vertical, and oblique. The aim of this ultrasound simulation study was to assess the risk of IPBSN injury associated with the type of skin incision and the point-of-emergence of the IPBSN relative to the sartorius muscle. Thirty healthy volunteers (60 lower limbs) were recruited for identification of the IPBSN. When it was found, using a high-frequency ultrasound probe, three different 3 cm skin incisions over the pes anserinus were simulated. Vertical, horizontal, or oblique lines simulating incisions were marked over the pes anserinus and ultrasound was used to visualize the structures that could be injured during the marked incisions. The IPBSN was visualized in 58 lower limbs (96.7%). The results of the simulation study indicated that the vertical incision should be avoided during hamstring tendon harvesting, as it is associated with a significantly higher risk of injury (25.9%) to the IPBSN than the horizontal (3.5%) or oblique (8.6%) incisions. We recommend that a preoperative ultrasound assessment of IPBSN anatomy be performed to minimize the risk of iatrogenic injury to the nerve and associated complications. Clin. Anat. 30:868-872, 2017. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Injury to the infrapatellar branch of the saphenous nerve during tendon graft harvesting for knee ligament reconstruction: An ultrasound simulation study

Pękala¹,

Miza

Henry³

et al. 2017

Clinical Anatomy

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“…При заборе сухожилий подколенных мышц имеется риск повредить две чувствительные ветви подкожного нерва -поднадколенниковая ветвь (иннервирует кожу переднемедиальной и переднелатеральной поверхностей коленного сустава) и портняжная терминальная веточка (идет вертикально по медиальной поверхности коленного сустава за портняжной мышцей, затем перфорирует фасцию между сухожилиями неж-ной и портняжной мышц и иннервирует кожу внутренней поверхности голени и голеностопного сустава) [25].…”

Section: Review Articles and Lecturesunclassified

The use of hamstring tendon graft for the anterior cruciate ligament reconstruction (benefi ts, problems and their solutions)

Сластинин¹,

Fayn²,

Vaza³

2017

Transplantologiâ (Mosk.)

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“…The IBSN supplies sensory innervation to the anteromedial aspect of the knee and the SBSN continues along the great saphenous vein to provide sensation to the medial aspect of the lower leg 6 . Iatrogenic nerve damage may cause hypoesthesia, dysesthesia, painful neuroma, reflex sympathetic dystrophy, anterior knee pain and kneeling pain 7 .…”

Section: Introductionmentioning

confidence: 99%

Posterior semitendinosus tendon harvesting minimizes the risk of injury to the infrapatellar and sartorial branches of the saphenous nerve

Kouloumentas¹,

Kavroudakis²,

Tsekouras³

et al. 2018

JRPMS

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There are several reports of iatrogenic injury to the saphenous nerve branches during anterior cruciate ligament (ACL) reconstruction attributed to tendon harvesting through an anterior approach. Other investigators advocate that there is virtually no nerve damage when the tendons are harvested through a posteromedial knee incision. The aim of the present study was to compare the incidence of iatrogenic injury to the infrapatellar and sartorial branches of the saphenous nerve with anterior and posterior tendon harvesting. A prospective, randomized clinical study was conducted comparing patients treated with ACL reconstruction employing the conventional technique with a semitendinosus/gracilis autograft versus the all-inside technique with a short, quadrupled semitendinosus autograft. Tendon harvesting for these two groups was performed through the anterior and the posterior approach, respectively. Skin sensation of the anterior aspect of the operated knee and tibia was assessed by the pin prick test and was compared to the contralateral side. No sensory alterations were noted on the anteromedial aspect of the operated knee and tibia in patients of the posterior harvest group.

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Saphenous nerve injury during hamstring tendons harvest: Does the incision matter? A systematic review

Abstract: Systematic review, Level II.

Cited by 47 publications

References 24 publications

Injury to the infrapatellar branch of the saphenous nerve during tendon graft harvesting for knee ligament reconstruction: An ultrasound simulation study

Injury to the infrapatellar branch of the saphenous nerve during tendon graft harvesting for knee ligament reconstruction: An ultrasound simulation study

The use of hamstring tendon graft for the anterior cruciate ligament reconstruction (benefi ts, problems and their solutions)

Posterior semitendinosus tendon harvesting minimizes the risk of injury to the infrapatellar and sartorial branches of the saphenous nerve

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