A study on vertical and oblique incision for hamstring graft harvest and its relationship with peri-incisional dysesthesia

Abstract

Background: The incidence of Infra Patellar Branch of Saphenous Nerve (IPBSN) ranges from 12 to 84%. Hamstring harvest performed using vertical incision results in IPBSN injury more commonly than oblique incision.Aim: To assess and compare the prevalence of infra patellar branch of saphenous nerve injury with vertical and oblique incision during hamstring graft harvest.Methodology: This was an observational analytical study, which was conducted over a period of time from January to December 2017 at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with isolated ACL injury with or withoutt meniscal injury fulfilling the inclusion and exclusion criteria were the study participants. After obtaining necessary permissions and consent, the patients were divided into two groups (vertical and oblique incision group) for Hamstring graft harvest. Data on socio-demographic characteristics, surgery details and outcomes were obtained. The sensitivity and functional outcome were assessed at 1st 3rd & 6th month by using Highet’s scale and Tegner Lysholm score respectively. The data obtained were entered into excel and analysed using SPSS v16. Results: A total of 60 patients (30 in each group) participated and in our study. On comparing dysesthesia using Highet’s scale in both the groups, oblique incision had 13% dysesthesia and vertical incision had 36% dyesthesia which was statistically significant with a p value of 0.037. The functional outcome which was assessed by Lysholm score in both vertical and oblique incision groups did not show any statistical difference Conclusion: Infra patellar branch of saphenous nerve injury was assessed using Highet’s scale in hamstring graft harvest and we found that oblique incision had a lesser incidence of injury compared to vertical incision and this was statistically significant. However there was no difference in the functional outcome in both the groups.