Two transverse versus single longitudinal incisions for patella tendon harvest in anterior cruciate ligament reconstruction

Abstract

The bone–patellar–bone autograft is the most commonly used graft in anterior cruciate ligament (ACL) reconstruction surgery. However, harvesting of the graft is associated with various local complications. Harvesting the graft via two transverse incisions rather than one longitudinal incision lowers the risk of injury to the infrapatellar branch of the saphenous nerve. Retrospective review of prospectively collected data. We compared the results of 38 consecutive patients who underwent arthroscopic ACL reconstruction between 12 and 20 months postoperatively. Group A (n = 16) consisted of patients in whom a single longitudinal incision had been used. Group B (n = 22) consisted of patients in whom harvest had been via two transverse incisions. The mean area of diminished sensation in Group A was 60.48 cm2, range 0–195, and in Group B was 32.19 cm2, range 0–132 (P = 0.028, t-test). The width and pigmentation of the scars were significantly less with the two transverse incisions technique. There was no significant difference between the two groups in any other tested parameter. The use of two transverse incisions was associated with a reduced area of altered sensation and objective evidence of a more cosmetically acceptable scar. We advocate the routine use of the two transverse incisions technique for graft harvest in ACL reconstructive surgery.