Injury to the Infrapatellar Branch of the Saphenous Nerve during ACL Reconstruction with Hamstring Tendon Autograft: A Comparison between Oblique and Vertical Incisions.

Background Injury to the infrapatellar branch of the saphenous nerve (IPBSN) is common after arthroscopic ACL reconstruction with hamstring tendon autograft, as reported in up to 88% of the cases. Due to close relationship between the IPBSN with pes anserine tendons insertion skin incision may sever IPBSN while harvesting gracillis and semitendinous tendons. As the IPBSN course at the anterior of knee is oblique, we hypothesized a parallel skin incision with nerve passage may decrease nerve injury. Methods Vertical and oblique incisions were compared in 79 patients in this clinical trial. The sensory loss area and patients' complain of numbness were measured at 2 and 8 weeks as well as 6 months after surgery. Results Both the sensory loss area and patients' complain of numbness decreased significantly in the oblique incision group (P<0001). Conclusion According to our findings, oblique incision is suggested instead of traditional vertical incision when hamstring tendons are being harvested in arthroscopic ACL reconstruction with hamstring tendon autograft.Level of evidence: IV.