Gali Julio Cesar, Holtz Rodrigo de Souza, Lepispico Marcello Scimini, Barrio Enzo, Senechal João Otavyo Pereira Le, Gali Julio Cesar
Pontificia Universidade Paulista, Faculdade de Ciencias Medicas, Sorocaba, SP, Brazil.
Pontificia Universidade Paulista, Faculdade de Ciencias Medicas, Nucleo de Ortopedia e Traumatologia Esportiva, Sao Paulo, SP, Brazil.
Acta Ortop Bras. 2024 Oct 7;32(4):e277962. doi: 10.1590/1413-785220243204e277962. eCollection 2024.
To evaluate the incidence of injuries to the infrapatellar branch of the saphenous nerve (IPBSN) after anterior cruciate ligament reconstruction (ACLR) with an oblique incision for hamstring graft harvesting.
In total, 59 knees (from 57 patients) were evaluated in the follow-up of ACLR for six months. We drew a horizontal line parallel to the ground, passing through the most medial portion of the surgical incision and another, perpendicular to the first, starting at the tibial tuberosity (TT). We measured the length and angle of the cut, the distances from its most medial point to the perpendicular line, and from the TT to the horizontal line. Skin sensitivity was tested with a brush and the altered sensitivity area was measured. Patients were asked about difficulties in activities daily of living (ADL).
A total of 27 knees (45.7%) had sensory disorders, which persisted until the sixth postoperative month in 92.6% of them. The ADL were compromised in one knee (3.7%). No significant differences were found between the groups with and without changes in sensitivity regarding age, affected side, incision angle, or measured distances. The incision size was larger in the group without alteration in sensitivity.
An oblique incision did not avoid IPBSN injuries. This condition rarely compromised the ADL.
评估采用斜切口取腘绳肌移植物进行前交叉韧带重建（ACLR）后隐神经髌下支（IPBSN）损伤的发生率。
对57例患者的59个膝关节进行了6个月的ACLR随访评估。我们绘制了一条与地面平行的水平线，该线穿过手术切口的最内侧部分，以及另一条从胫骨结节（TT）开始、与第一条线垂直的线。我们测量了切口的长度和角度、其最内侧点到垂直线的距离以及从TT到水平线的距离。用刷子测试皮肤敏感性，并测量感觉改变的区域。询问患者日常生活活动（ADL）方面的困难。
共有27个膝关节（45.7%）存在感觉障碍，其中92.6%的患者术后第六个月仍持续存在。1个膝关节（3.7%）的ADL受到影响。在感觉有无变化的两组之间，在年龄、患侧、切口角度或测量距离方面未发现显著差异。感觉无改变组的切口尺寸更大。
斜切口并不能避免IPBSN损伤。这种情况很少影响ADL。
