Saphenous nerve injury after anterior cruciate ligament reconstruction: Reduced numbness area after ligamentoplasty using quadriceps tendon compared with hamstring tendon

• Published in: The knee Vol. 27; no. 4; pp. 1151 - 1157
• Main Authors: Horteur, C., Cavalié, G., Gaulin, B., Cohen Bacry, M., Morin, V., Cavaignac, E., Pailhé, R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2020; Elsevier Limited
• Subjects: Adult; Anterior cruciate ligament; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - adverse effects; Anterior Cruciate Ligament Reconstruction - methods; Autografts; Cohort Studies; Data collection; Female; Hamstring Tendons - transplantation; Humans; Hypesthesia; Hypotheses; Infra-patellar branch; Knee; Male; Middle Aged; Morbidity; Numbness; Patella - innervation; Patients; Peripheral Nerve Injuries - epidemiology; Quadriceps muscle; Quadriceps Muscle - surgery; Retrospective Studies; Saphenous nerve; Software; Surgeons; Tendons - transplantation; Tibia - surgery; Transplantation, Autologous; Young Adult; Infra-patellar branch; Anterior cruciate ligament; Numbness; Saphenous nerve
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2020.05.020

Injury to the infra-patellar branches of the saphenous nerve (IPBSN) is the main neurological complication of anterior cruciate ligament (ACL) reconstruction procedures. Surgical technique using quadriceps tendon (QT) autograft allows a less invasive tibial approach potentially protecting the IPBSN. The aim of this study was to compare the numbness surface of the cutaneous area supplied by the IPBSN after ACL reconstruction using either hamstring tendon (HT) or QT autografts. This was a retrospective comparative cohort study including 51 patients who underwent ACL reconstruction (27 QT and 24 HT) between January 2017 and April 2018. A sensory clinical evaluation was performed on each patient: length of the tibial scar, eventual numbness surface area and the type of sensory disorder were reported. To be considered as an IPBSN lesion, the numbness area had to spread at least one-centimeter away from the scar. The average follow-up was 15 months. In the HT group, the numbness area surface measured 21.2 ± 19 cm2 (0–77) and the scar length was on average 31.3 ± 5.6 mm. In the QT group, the numbness area was reduced to 5 ± 10 cm2 (P = .0007) as well as the scar length (13.3 ± 2.8 mm, P < .0001). We counted five (17.8%) and 19 (76%) real IPBSN lesions in the QT and HT groups, respectively (P = .0002). Hypoesthesia was the main sensory disorder observed (87.5%). Numbness area of the cutaneous surface supplied by the IPBSN after ACL reconstruction is reduced using QT autograft compared with HT autograft.