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Knee ; 27(4): 1151-1157, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32711876

RESUMO

PURPOSE: 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. METHODS: 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. RESULTS: 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%). CONCLUSION: Numbness area of the cutaneous surface supplied by the IPBSN after ACL reconstruction is reduced using QT autograft compared with HT autograft.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Tendões dos Músculos Isquiotibiais/transplante , Patela/inervação , Traumatismos dos Nervos Periféricos/epidemiologia , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Estudos de Coortes , Feminino , Humanos , Hipestesia , Masculino , Pessoa de Meia-Idade , Músculo Quadríceps/cirurgia , Estudos Retrospectivos , Tendões/transplante , Tíbia/cirurgia , Transplante Autólogo , Adulto Jovem
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