Relationship between different skin incisions and the injury of the infrapatellar branch of the saphenous nerve during anterior cruciate ligament reconstruction

Saphenous nerve injury during hamstring tendons harvest: Does the incision matter? A systematic review

“…In our opinion, routinely surgical nerve exploration seems to be excessive, principally considering the recorded higher rate of ineffectiveness of this approach. The most effective method aimed to reduce infrapatellar branch damaging according to several authors is represented by the adoption of an oblique or horizontal orientation of the incision for pes anserinus tendon harvest [12,13,16].…”

“…For this reason, many authors postulated that an horizontal or oblique incision should permit to spare the infrapatellar branch being parallel to the nerve branches course [12,13,16].…”

Lesão do nervo safeno na retirada de 1 ou 2 tendões flexores na reconstrução do ligamento cruzado anterior

“…8,9 A lesão mais comum é do ramo infrapatelar (IPNS), que cruza a região anterior do joelho bem inferior à patela 14 e fica perpendicular e em risco de lesão devido à incisão vertical da retirada dos tendões flexores e da própria lesão pelo portal de artroscopia. 14, 15 Luo et al 10 compararam a incidência de lesão nervosa com a retirada dos tendões flexores entre a incisão obliqua e vertical e concluíram que a incisão oblíqua levou uma taxa de 24% de lesão nervosa contra 56% na incisão vertical.…”

Ultrasound-Guided Needle Localization of the Saphenous Nerve for Removal of Neuroma in the Infrapatellar Branches

“…The arthroscopy portals necessary for ACL reconstruction make nerve damage a common occurrence often leading to painful neuroma. 13,14 Patients classically present with severe sharp well-localized anteromedial knee pain that is exacerbated by physical stimulation and certain movements. The pain may be superficial or deep, constant or intermittent.…”