The prognosis of iatrogenic saphenous nerve injuries during hamstring tendon harvesting in anterior cruciate ligament reconstruction.

Publisher: BioMed Central Country of Publication: England NLM ID: 101265112 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-799X (Electronic) Linking ISSN: 1749799X NLM ISO Abbreviation: J Orthop Surg Res Subsets: MEDLINE

Original Publication: London : BioMed Central, 2006-

Anterior Cruciate Ligament Reconstruction*/adverse effects ; Anterior Cruciate Ligament Reconstruction*/methods ; Hamstring Tendons*/transplantation ; Iatrogenic Disease*; Humans ; Female ; Male ; Adult ; Retrospective Studies ; Young Adult ; Prognosis ; Peripheral Nerve Injuries/etiology ; Tissue and Organ Harvesting/adverse effects ; Tissue and Organ Harvesting/methods ; Adolescent ; Follow-Up Studies ; Middle Aged ; Patient Satisfaction ; Recovery of Function ; Incidence ; Treatment Outcome

Purpose: This study aims to evaluate the long-term outcomes of saphenous nerve (SN) injuries from hamstring tendon harvesting during ACL reconstruction, focusing on clinical results and patient satisfaction after at least two years. Additionally, it investigates the incidence, recovery patterns, and impact of these injuries on functional outcomes, daily activities, and ACL re-rupture rates immediately post-surgery and at final follow-up.
Materials and Methods: A retrospective review was conducted on patients who had undergone ACL reconstruction with hamstring tendon grafts at a single institution between January 2015 and January 2020. The incidence of SN injuries was assessed immediately after surgery and at final follow-up. Additionally, the recovery rate and time were evaluated, and the impact of these injuries on functional outcomes was measured using the Lysholm Knee Score (LKS) and patient-reported effects on daily activities.
Results: Of the 159 patients analyzed, iatrogenic SN injuries were initially observed in 87 (54.7%) patients post-ACLR. By the final follow-up, paresthesia had resolved in 36 (22.6%) patients within an average of 11.1 months. Persistent SN injuries were recorded in 51 (32.1%) patients, affecting various extents of the infrapatellar branch (IPBSN) and the sartorial branch (SBSN) of the saphenous nerve. Patients with persistent SN injuries experienced a significant impact on daily activities and had lower LKS scores compared to those without injuries or with recovered injuries. Furthermore, a higher re-rupture rate was associated with persistent SN injuries.
Conclusions: The study finds that SN injuries during hamstring graft harvesting for ACL reconstruction are common, with a significant portion of patients experiencing persistent sensory deficits for at least two years postoperatively. These injuries are observed to adversely affect patient satisfaction and functional outcomes and to increase the re-rupture rate.
(© 2024. The Author(s).)

Arch Bone Jt Surg. 2018 Jan;6(1):52-56. (PMID: 29430496)
Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3140-3145. (PMID: 27338956)
Arthroscopy. 2001 Nov-Dec;17(9):971-80. (PMID: 11694930)
Med Hypotheses. 2005;64(6):1166-9. (PMID: 15823709)
J Nepal Health Res Counc. 2016 Sep;14(34):180-185. (PMID: 28327683)
Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2089-95. (PMID: 23073817)
Sports Med Arthrosc Rev. 2020 Jun;28(2):41-48. (PMID: 32345925)
Arthroscopy. 2018 Sep;34(9):2524-2525. (PMID: 30173789)
Clin Orthop Relat Res. 2013 Aug;471(8):2602-10. (PMID: 23666590)
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499017690995. (PMID: 28219309)
Chin Med J (Engl). 2007 Jul 5;120(13):1127-30. (PMID: 17637238)
EFORT Open Rev. 2021 Sep 14;6(9):808-815. (PMID: 34667652)
Orthopedics. 2013 Feb;36(2):90-2. (PMID: 23379658)
Arthroscopy. 2000 Oct;16(7):763-6. (PMID: 11027764)
J Bone Joint Surg Br. 1990 May;72(3):398-404. (PMID: 2341436)
Knee. 2019 Jun;26(3):660-665. (PMID: 30902515)
Int Orthop. 2015 Mar;39(3):527-34. (PMID: 25192689)
Arthroscopy. 2007 Sep;23(9):956-63. (PMID: 17868834)
J Exp Orthop. 2022 Nov 3;9(1):109. (PMID: 36326935)
Ir J Med Sci. 2015 Mar;184(1):201-6. (PMID: 24535194)
Rev Bras Ortop (Sao Paulo). 2020 Jun;55(3):374-379. (PMID: 32616985)
Acta Orthop Belg. 2008 Oct;74(5):643-51. (PMID: 19058699)
Am J Sports Med. 1993 Jul-Aug;21(4):565-71. (PMID: 8368418)
Knee. 2016 Jan;23(1):106-10. (PMID: 26753501)
Knee Surg Sports Traumatol Arthrosc. 2004 May;12(3):198-202. (PMID: 14625669)
Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):146-152. (PMID: 30019072)
Muscle Nerve. 2017 Nov;56(5):930-937. (PMID: 28120438)
Knee Surg Sports Traumatol Arthrosc. 2020 Mar;28(3):969-974. (PMID: 31270589)
Knee. 2017 Jun;24(3):564-569. (PMID: 28404457)
J Bone Joint Surg Am. 2013 Dec 4;95(23):2119-25. (PMID: 24306699)
Arch Trauma Res. 2013 Dec;2(3):118-23. (PMID: 24693521)
Knee Surg Sports Traumatol Arthrosc. 2018 Aug;26(8):2410-2423. (PMID: 29423546)
J R Soc Med. 1998 Nov;91(11):573-5. (PMID: 10325872)
J Orthop Surg Res. 2017 Jun 27;12(1):101. (PMID: 28655325)
Knee Surg Sports Traumatol Arthrosc. 2006 Aug;14(8):789-93. (PMID: 16328463)
J Knee Surg. 2018 Jul;31(6):585-590. (PMID: 28841726)
Ann Thorac Surg. 2008 Mar;85(3):896-900. (PMID: 18291167)
Orthop Traumatol Surg Res. 2017 Dec;103(8S):S245-S248. (PMID: 28888527)
Knee. 2020 Jun;27(3):709-716. (PMID: 32563427)
Arthroscopy. 2023 Mar;39(3):613-622. (PMID: 36309227)
J Orthop Surg Res. 2021 Mar 22;16(1):206. (PMID: 33752724)
J ISAKOS. 2023 Jun;8(3):153-162. (PMID: 36410671)
Clin Orthop Relat Res. 1985 Sep;(198):43-9. (PMID: 4028566)
Am J Sports Med. 2000 Jul-Aug;28(4):562-7. (PMID: 10921651)
Surg Radiol Anat. 2004 Jun;26(3):167-71. (PMID: 14648039)
Rev Bras Ortop. 2015 Aug 29;50(5):546-9. (PMID: 26535201)
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3871-3876. (PMID: 33486558)
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):1060-4. (PMID: 24482218)
Int J Sports Med. 2008 Jun;29(6):507-11. (PMID: 18574873)
Knee. 2008 Oct;15(5):360-3. (PMID: 18583136)

Date Created: 20240725 Date Completed: 20240725 Latest Revision: 20240728

20240728

PMC11267848

10.1186/s13018-024-04929-z

39049103