Journal of ISAKOS : joint disorders & orthopaedic sports medicine · 2026
Oblique incision is associated with lower sensory loss compared with vertical incision for hamstring harvest in anterior cruciate ligament reconstruction: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Yuwarungsikul Chulayut, Veerathumjumras Potsawat, Ratanachai Natakrit, Thamrongskulsiri Napatpong, Limskul Danaithep, Tanpowpong Thanathep, Kuptniratsaikul Somsak, Itthipanichpong Thun
Аннотация
IMPORTANCE: The infrapatellar branch of the saphenous nerve (IPBSN) is commonly injured during hamstring tendon harvest for anterior cruciate ligament (ACL) reconstruction, leading to peri-incisional sensory loss and patient dissatisfaction. Incision orientation may influence this risk.
OBJECTIVE: To systematically review and meta-analyze randomized controlled trials (RCTs) comparing oblique versus vertical skin incisions for hamstring tendon harvest in primary ACL reconstruction with respect to postoperative sensory loss and functional outcomes.
EVIDENCE REVIEW: A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to September 2025. Eligible studies were RCTs comparing oblique versus vertical incisions for hamstring harvest in primary ACL reconstruction. The primary outcome was the incidence of peri-incisional sensory loss. Secondary outcomes included the area of sensory loss and patient-reported outcome measures, including Lysholm and International Knee Documentation Committee (IKDC) scores. Outcomes were pooled using random-effects meta-analysis and expressed as risk ratios (RR) or mean differences (MD) with 95% confidence interval (CI); heterogeneity was assessed with I2.
FINDINGS: Eight RCTs involving 626 patients were included. Oblique incisions were associated with a significantly lower incidence of sensory loss compared with vertical incisions (RR: 0.64, 95% CI: 0.49-0.84; I2 = 73.6%). The area of sensory loss was also reduced with oblique incisions (MD -29 cm2, 95% CI -46 to -13; I2 = 96.6%). Two trials reported functional outcomes using Lysholm or IKDC scores, and none demonstrated statistically significant differences between incision types.
CONCLUSION AND RELEVANCE: Oblique skin incision for hamstring tendon harvest in ACL reconstruction appears to be associated with a lower incidence and smaller area of peri-incisional sensory loss compared with vertical incisions, without clear differences in functional outcomes. However, the certainty of evidence is low due to substantial heterogeneity and methodological limitations among included trials. Oblique incision may be considered a preferred technique to reduce sensory morbidity.
LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis of RCTs.
OBJECTIVE: To systematically review and meta-analyze randomized controlled trials (RCTs) comparing oblique versus vertical skin incisions for hamstring tendon harvest in primary ACL reconstruction with respect to postoperative sensory loss and functional outcomes.
EVIDENCE REVIEW: A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to September 2025. Eligible studies were RCTs comparing oblique versus vertical incisions for hamstring harvest in primary ACL reconstruction. The primary outcome was the incidence of peri-incisional sensory loss. Secondary outcomes included the area of sensory loss and patient-reported outcome measures, including Lysholm and International Knee Documentation Committee (IKDC) scores. Outcomes were pooled using random-effects meta-analysis and expressed as risk ratios (RR) or mean differences (MD) with 95% confidence interval (CI); heterogeneity was assessed with I2.
FINDINGS: Eight RCTs involving 626 patients were included. Oblique incisions were associated with a significantly lower incidence of sensory loss compared with vertical incisions (RR: 0.64, 95% CI: 0.49-0.84; I2 = 73.6%). The area of sensory loss was also reduced with oblique incisions (MD -29 cm2, 95% CI -46 to -13; I2 = 96.6%). Two trials reported functional outcomes using Lysholm or IKDC scores, and none demonstrated statistically significant differences between incision types.
CONCLUSION AND RELEVANCE: Oblique skin incision for hamstring tendon harvest in ACL reconstruction appears to be associated with a lower incidence and smaller area of peri-incisional sensory loss compared with vertical incisions, without clear differences in functional outcomes. However, the certainty of evidence is low due to substantial heterogeneity and methodological limitations among included trials. Oblique incision may be considered a preferred technique to reduce sensory morbidity.
LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis of RCTs.