Injury to the internal saphenous nerve as a complication in primary autograft anterior cruciate ligament plasty (hamstring) comparison between vertical and oblique incisions

Abstract

INTRODUCTION: The internal saphenous nerve is a sensitive branch of the crural nerve, which at the level of the knee gives an infrapatellar branch (RIP) that innervates its anterior aspect and a terminal unit (RTS) that supplies sensory innervation to the anterior and posteromedial sectors of the leg. In arthroscopic surgery, either through the portals used or through the skin incisions for taking autografts, both branches can be injured and generate sensitivity disorders of varying intensity.

OBJECTIVE: To evaluate the incidence of internal saphenous nerve injury and its impact during the postoperative period, emphasizing reconstructive techniques that use hamstring autografts.

MATERIALS AND METHOD: Between January 2018 and February 2019, 15 anterior cruciate ligament plasties with Hamstring autograft with vertical incision were compared with 15 patients who underwent anterior cruciate ligament plasties with Hamstring autograft with the oblique incision. The Age group comprised patients between 20 - 50 years. Lysholm functional scales were performed. Range of motion and pain were measured at 1, 3 - 6 - 12 months.

RESULTS: The average follow-up was one year (3 - 11 months) for Plasties of Anterior Cruciate Ligament with Hamstring autograft with Oblique incision group and one year (4 - 11 months) for Plasty of Anterior Cruciate Ligament Autograft Hanstring with Incision Vertical group. There were no significant differences in terms of functional scales in the medium term.

CONCLUSIONS: Based on our findings, the oblique incision is suggested instead of the traditional vertical incision when Hamstring tendons are removed in arthroscopic ACL reconstruction with hamstring autograft.