RISK OF IATROGENIC INJURY TO THE INFRAPATELLAR BRANCH OF THE SAPHENOUS NERVE DURING HAMSTRING TENDON HARVESTING: A META-ANALYSIS

Introduction: Our goal was to conduct a comprehensive analysis of studies reporting data on the rate of injury to the infrapatellar branch of the saphenous nerve following hamstring tendon graft harvesting with respect to the type of incision over the pes anserinus. Methods: A broad search through all major electronic databases was conducted to identify articles eligible for inclusion. All available data were extracted and pooled into the analysis. Results: Eleven studies (n=1,050 patients) were included in the meta-analysis. The study revealed that a vertical incision during hamstring tendon harvesting over the pes anserinus was associated with the highest rate of injury with a pooled rate of 51.4% (95% confidence interval [CI], 34.6-67.2%). This was followed by oblique and horizontal incisions with pooled rates of 26.0% (95% CI,1.3-61.3%) and 22.4% (95% CI, 5.4-45.5%), respectively. Conclusions: We highly recommend the use of the shortest possible oblique incision during hamstring tendon harvesting over the pes anserinus.