Duraiswamy Gopinath, Ashraf Munis, Paul Earnest, K Santosh Sahanand, Rajan David V
Ortho One Orthopaedic speciality centre, coimbatore, India.
Be Well Hospitals, Chennai, India.
J Clin Orthop Trauma. 2024 Dec 9;60:102865. doi: 10.1016/j.jcot.2024.102865. eCollection 2025 Jan.
This randomized controlled trial aimed to evaluate the impact of different incision types (oblique, vertical, and horizontal) for hamstring graft harvest on sensory disturbances and functional outcomes after anterior cruciate ligament (ACL) reconstruction.
A total of 118 patients were randomized into three groups: oblique incision (n = 40), vertical incision (n = 40), and horizontal incision (n = 38). Sensory deficits were assessed using Von Frey Filaments at three weeks, three months, and six months postoperatively. Functional outcomes were measured using the International Knee Documentation Committee (IKDC) 2000 Subjective Knee Evaluation score at the 6-month mark. Statistical analyses included ANOVA and post-hoc tests to compare sensory disturbances across groups.
At 6 months, the oblique incision group demonstrated significantly less sensory disturbance (34.7 mm ± 38.6) than the vertical (43.8 mm ± 39.1) and horizontal (63.4 mm ± 42.4) incision groups (p = 0.031). No significant differences were found between the oblique and vertical incisions. The functional outcomes were comparable across all groups (P > 0.05).
Compared with vertical and horizontal incisions, oblique incisions for hamstring graft harvesting significantly reduced sensory disturbances without compromising functional outcomes. These findings suggest that careful selection of incision type can improve postoperative sensory outcomes in ACL reconstruction.
本随机对照试验旨在评估在前交叉韧带（ACL）重建术中，不同类型的切口（斜切口、垂直切口和水平切口）获取腘绳肌移植物对感觉障碍和功能结局的影响。
118例患者被随机分为三组：斜切口组（n = 40）、垂直切口组（n = 40）和水平切口组（n = 38）。术后3周、3个月和6个月时，使用von Frey细丝评估感觉缺陷。在6个月时，使用国际膝关节文献委员会（IKDC）2000主观膝关节评估评分来测量功能结局。统计分析包括方差分析和事后检验，以比较各组间的感觉障碍情况。
在6个月时，斜切口组的感觉障碍（34.7 mm±38.6）明显少于垂直切口组（43.8 mm±39.1）和水平切口组（63.4 mm±42.4）（p = 0.031）。斜切口和垂直切口之间未发现显著差异。所有组的功能结局具有可比性（P>0.05）。
与垂直切口和水平切口相比，采用斜切口获取腘绳肌移植物可显著减少感觉障碍，且不影响功能结局。这些发现表明，仔细选择切口类型可改善ACL重建术后感觉结局。
