Saphenous nerve injury after anterior cruciate ligament reconstruction

Abstract

Introduction. Iatrogenic injury to the infrapatellar branch of the saphenous nerve is the most common complication after anterior cruciate ligament reconstruction. The aim of the study is to present the incidence, analyze risk factors, and possibilities of prevention. Material and Methods. One year after bone-patellar tendon-bone surgery, we surveyed 787 patients, 78.3% males, with mean age 27.7 years (14 - 59), mean height 180.6 cm (154 - 207), and mean weight 81.8 kg (46 - 145). We monitored the incidence of anterolateral skin numbness below the operated knee joint. Results and Discussion. Of the total number of examinees, 71.8% had a feeling of numbness, while 27.3% reported constant numbness. In the group of patients with a higher body mass, the feeling of numbness occurred significantly less often compared to the group with lower body mass, as was the case in the tallest patients, who reported numbness significantly less often compared to the shortest (p < 0.001). The incidence of anterolateral skin numbness was lowest among basketball players (64.5%) and highest among skiers (84.8%). Numbness was not significantly affected by age, laterality, and body mass index, level of sports activity, competition ranking or time until surgery. The horizontal surgical incision, intraoperative identification of the nerve, minimally invasive surgery, and the choice of bone graft harvesting sites, can reduce the complication rate. Conclusion. One year after the anterior cruciate ligament reconstruction, every fourth patient felt constant anterolateral skin numbness of the operated knee. Although this did not significantly affect the quality of life, it can be prevented by the surgeon who is obliged to warn every candidate for surgery about the possibility of complications, especially short and slim persons.