Sensibility loss after ACL reconstruction with hamstring graft.

Area of Science:

• Orthopedic Surgery
• Neuroscience
• Sports Medicine

Background:

• Anterior cruciate ligament (ACL) reconstruction frequently results in infrapatellar branch of the saphenous nerve (IPBSN) injury.
• This nerve injury leads to regional hypoesthesia in the lower leg post-surgery.

Purpose of the Study:

• To evaluate if graft harvest incision orientation impacts the prevalence of postoperative hypoesthesia.
• To assess changes in the hypoesthetic area during the first year after ACL reconstruction.
• To test the hypothesis that an oblique incision reduces complication incidence and sensory loss compared to a vertical incision.

Main Methods:

• Fifty patients undergoing primary ACL reconstruction with hamstring grafts were studied.
• Patients were divided into two groups: 25 with vertical incisions and 25 with oblique incisions for graft harvest.
• Sensibility of the lower leg was examined 12 days and one year post-surgery.

Main Results:

• Hypoesthesia is a prevalent complication (88%) following hamstring ACL surgery.
• A shift from vertical to oblique incisions did not decrease the incidence or severity of hypoesthesia.
• The area of sensory loss significantly decreased by 46.3% at the one-year follow-up.

Conclusions:

• Incision orientation during hamstring graft harvest does not influence the occurrence of postoperative hypoesthesia after ACL reconstruction.
• Despite initial hypoesthesia, the affected sensory area naturally diminishes significantly within the first year.
• Further research may explore nerve-sparing techniques to mitigate IPBSN injury during ACL surgery.