The effect of preoperative ultrasound localization on the incidence of infrapatellar branch of the saphenous nerve injury after hamstring tendon harvesting.

IF 2.8 3区 医学 Q1 ORTHOPEDICS
Tianli Du, Jianfeng Chen, Chao Yan, Hongzhi Fang, Zhenghui Shang
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引用次数: 0

Abstract

Background: The potential of ultrasound-guided labelling of the inferior patellar branch of the saphenous nerve (IPBSN) to reduce IPBSN injury during anterior cruciate ligament reconstruction (ACLR) has not been explored. The primary objective of this retrospective cohort analysis was to assess whether intraoperative hamstring tendon harvesting avoiding the marked IPBSN would be effective in reducing the incidence of postoperative skin sensory disturbances and the mean area of sensory disturbances.

Methods and analysis: A retrospective cohort study involving 60 patients who underwent autograft ACLR at Yichang Central People's Hospital from October 2020 to October 2024 was conducted. Patients were divided into two groups on the basis of the use of preoperative ultrasound localization of the IPBSN, including the nonultrasound localization group (control group) and the ultrasound localization group (experimental group), with 30 patients in each group. The control group underwent standard ACLR with a diagonal incision for hamstring tendon harvesting, whereas the experimental group underwent preoperative ultrasound-guided localization of the IPBSN to avoid the nerve during incision. The primary outcome measures include the incidence of skin sensory disturbances and the average sensory disturbance area. The secondary outcomes include the Lysholm score and VAS score at the 6-month postoperative follow-up.

Results: The incidence of skin sensory disturbances in the experimental group was lower than that in the control group, and the average area of sensory disturbance was smaller in the experimental group (P < 0.05). At the 6-month postoperative follow-up, no statistically significant differences in the Lysholm knee scores or visual analogue scale (VAS) pain scores were noted between the two groups (P > 0.05).

Conclusion: Preoperative ultrasound-guided localization of the IPBSN can reduce the risk of nerve injury during ACLR. The ultrasound-guided approach leads to a lower incidence of sensory disturbances and a smaller average area of sensory disturbance. IPBSN injury was not related to anterior knee pain or knee ROM limitations. Patients can choose whether to use ultrasound localization before surgery according to their needs. The study protocol adhered to strict standards of ethical conduct and patient safety. The results of this trial are expected to provide valuable insights into the prevention of injury to the IPBSN during hamstring tendon harvesting.

术前超声定位对腘绳肌腱切除术后隐神经髌下支损伤发生率的影响。
背景:超声引导下标记隐神经髌下支(IPBSN)在前交叉韧带重建(ACLR)中减少IPBSN损伤的潜力尚未探讨。本回顾性队列分析的主要目的是评估术中腘绳肌腱切除避免标记IPBSN是否能有效减少术后皮肤感觉障碍的发生率和平均感觉障碍面积。方法与分析:对2020年10月至2024年10月在宜昌市中心人民医院行自体ACLR手术的60例患者进行回顾性队列研究。根据术前超声定位IPBSN的使用情况,将患者分为非超声定位组(对照组)和超声定位组(实验组),每组30例。对照组行标准ACLR斜切口切除腘绳肌腱,实验组术前行超声引导下定位IPBSN,以避免切口时损伤神经。主要观察指标包括皮肤感觉障碍的发生率和平均感觉障碍面积。次要结局包括术后6个月随访时Lysholm评分和VAS评分。结果:实验组皮肤感觉障碍发生率低于对照组,平均感觉障碍面积小于对照组(P < 0.05)。结论:术前超声引导下定位IPBSN可降低ACLR中神经损伤的风险。超声引导入路的感觉障碍发生率较低,平均感觉障碍面积较小。IPBSN损伤与膝关节前侧疼痛或膝关节活动度限制无关。患者可以根据自己的需要选择术前是否使用超声定位。研究方案严格遵守道德行为和患者安全标准。该试验的结果有望为在腘绳肌腱收获过程中预防IPBSN损伤提供有价值的见解。
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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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