The impact of sensory deficits after harvesting hamstrings autograft for ACL reconstruction.
OBJECTIVE
The aim of this study was threefold: to investigate the incidence of sensory deficits after harvesting hamstrings autografts, to localise and measure the area of altered sensibility and to investigate the impact of any sensory deficit on the patients daily life.


METHODS
A consecutive series of sixty-one patients were examined for sensory deficits related to harvest of hamstrings tendons 10 years after having had an anterior cruciate ligament reconstruction. A neurological examination of the leg was performed to investigate for potential altered sensibility and to quantify the extent of the lesion. The patients answered the anterior knee symptoms (AKS) questionnaire and additional questions regarding impact on activities of daily life by any sensory deficit.


RESULTS
Eighty-five per cent of the examined patients had sensory deficits--experienced as numbness (78 %) and paraesthesia (16 %)--distal to the site of tendon harvesting. The mean affected area was 70 (SD 62) cm(2). No patients experienced sensory deficit symptoms to such a degree that it affected their activities of daily life, but the group with sensory deficit had significantly more AKS than patients without sensory deficit, as evaluated by the AKS score (P = 0.02). The most commonly reported complaints were related to strenuous activities and kneeling knee position.


CONCLUSIONS
This long-term evaluation shows that sensory deficit after hamstring tendons harvesting affects a majority of patients and is probably permanent. Most patients reported this as being only mildly bothersome, but they have significantly more AKS as assessed by the AKS questionnaire. In clinical practice, patients should be counselled prior to tendon harvesting on the incidence and characteristic of the sensory deficit along with other possible peri- and postoperative complications.


METHODS
Case series, Level IV.
Surgical Department, Haraldsplass Deaconess Hospital, Pb 6165, 5152, Bergen, Norway, eivind.inderhaug@gmail.com.
Eivind
E
Inderhaug
Torbjørn
T
Strand
Eirik
E
Solheim
D000293:Adolescent; D000328:Adult; D000368:Aged; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D064592:Autografts; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007866:Leg / Q000294:innervation; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D012678:Sensation Disorders / Q000209:etiology*; D013710:Tendons / Q000637:transplantation; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014182:Transplantation, Autologous / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult