| Objective To observe the recovery of knee joint function after arthroscopic anterior cruciate ligament reconstruction,and to explore the related factors of skin sensory disturbance and its influence on the recovery of knee joint function.Materials and MethodsFrom January 2017 to December 2018,198 patients with anterior cruciate ligament injury who underwent arthroscopic ACL reconstruction with hamstring tendon autograft were retrospectively analyzed.The general case information,meniscus and cartilage injury,anterior drawer test results,IKDC score,Lysholm score,Tegner score,VAS score,incision direction and sensory disturbance area were recorded The incidence of knee pain and range of motion limitation were compared.Results1.The Lysholm score was significantly higher in patients with ACL injury after anterior cruciate ligament reconstruction with hamstring tendon autograft(t=13.001,P < 0.001),while VAS score was significantly lower than that before operation(t =13.353,P < 0.001).The positive rate of anterior drawer test was only 1.01%(2/198).2.There were no significant differences in age,gender,BMI,Lysholm score,VAS score,meniscus and cartilage injury between the two groups(P>0.05).3.The incidence of skin sensory disturbance in longitudinal incision group was higher than that in oblique incision group(χ~2= 6.114,P =0.013)and arc incision group(χ~2= 10.427,P = 0.001).The incidence of skin sensory disturbance in oblique incision group was still higher than that in arc incision group,but the difference was not statistically significant(χ~2= 0.670,P =0.413).4.The incidence of ipbsn injury was significantly higher in longitudinal incision than in oblique incision(χ~2= 5.573,P = 0.018),significantly higher than that in arc incision(χ~2= 13.050,P < 0.001),and the difference was statistically significant(χ~2= 13.117,P = 0.001);there was no significant difference in the incidence of leg Sb Sn injury between different incisions(χ~2= 0.458,P = 0.795).5.There was no significant difference in Lysholm score,IKDC score,VAS score,Tegner score,anterior knee pain and joint function limitation between the two groups(P>0.05).Conclusions1.Anterior cruciate ligament injury patients with autologous hamstring tendon reconstruction of anterior cruciate ligament surgery can effectively improve the knee joint function.2.Local skin sensory disturbance after anterior cruciate ligament reconstruction with autologous hamstring tendon is common,which is caused by saphenous nerve injury caused by hamstring tendon removal.3.The incidence of sensory disturbance caused by tendon removal in different directions was different.The incidence of sensory disturbance caused by longitudinal incision was the highest,while that of arc incision was the lowest.4.The incidence of sensory disturbance after anterior cruciate ligament reconstruction with autologous hamstring tendon is not related to age,gender and BMI.5.Sensory disturbance after anterior cruciate ligament reconstruction with autologous hamstring tendon does not affect the recovery of knee joint function.Objective To observe the anatomical relationship of saphenous nerve,semitendinosus muscle and gracilis muscle in anterior cruciate ligament reconstruction with autologous tendon,and to explore the possible injury location of saphenous nerve and its branches,and to determine the safe range of an operation incision.Materials and Methods The relationship between saphenous nerve and its branches,sartorius muscle,gracilis muscle and semitendinosus muscle was analyzed.The position of saphenous nerve and its branches and the safe range of surgical incision were calculated statistically.Results1.The lower patellar branch of saphenous nerve at the posterior margin of sartorius muscle is roughly parallel to the anterior edge of gracilis muscle,and has the closest relationship with it.Tendon incision is easy to cause injury;the safe range of surgical incision: the horizontal distance from the lower edge of tibial tubercle to the inferior patellar branch of saphenous nerve is 3.6±0.6cm(2.8-4.9cm).The inferior patellar branch of saphenous nerve was 29.1±4.7°(23-40°).2.At the point where the terminal branch of saphenous nerve passes through the deep fascia(i.e.the position where it intersects with gracilis muscle),the terminal branch of saphenous nerve may be damaged during the process of taking out the gracilis tendon with a key extractor.The vertical distance between the lower patellar branch of saphenous nerve and gracilis muscle was0.6±0.2cm(0.2-0.9cm),9.6±1.8cm(5.5-12.1cm)from the anterior border of tibia and 8.2±1.6cm(5.1-11.1cm)from the tibial insertion of gracilis muscle.Conclusions1.Popliteal tendon incision and tendon removal device may damage the inferior patellar branch or terminal branch of saphenous nerve.2.The safe range of the incision is 3.6cm from the lower edge of the tibial tubercle,and the angle between the incision and the horizontal line is 29.1 °. |
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