Summary

Comparing two hamstring graft harvesting techniques for ACL reconstruction, this study found significantly higher incidence and severity of sensory loss with the anteromedial longitudinal incision compared to the posterior popliteal fossa approach.

Abstract

Introduction

Hamstring grafts are widely used in anterior cruciate ligament reconstruction (ACLR), but sensory loss over the anterior upper leg is a common complication that can cause significant patient anxiety. This study compares the incidence and severity of sensory loss in patients undergoing ACLR using two different hamstring graft harvesting techniques.

Methodology

Sixty patients undergoing ACLR were divided into two groups. Group A (30 patients) had gracilis and semitendinosus grafts harvested via a 3 cm anteromedial longitudinal incision, while Group B (30 patients) had hamstring grafts harvested through a small popliteal fossa incision for posterior graft harvest.

Results

In Group A, the incidence of sensory loss was 93.33%, predominantly affecting the anterolateral leg (85.7%), with a smaller percentage around the harvest scar (14.2%). No sensory loss was observed in the medial leg. The average area of sensory loss was 150.97 cm² at 1 month, decreasing to 63.33 cm² at 6 months, with the incidence dropping to 42%. By 9 months, 42% of patients still experienced sensory loss, which further reduced to 13.3% at 1 year. In Group B, only 13.3% (4 out of 30) of patients experienced sensory loss, with an average area of 16 cm², which completely resolved before 6 months.

Conclusion

Sensory loss following hamstring graft harvest for ACLR is significantly more common and severe with the anteromedial longitudinal incision technique compared to the small popliteal fossa incision for posterior graft harvest. Further studies with extended follow-ups and detailed anatomical investigations are needed to better understand the underlying causes and to develop preventive measures.