A randomized controlled trial on oblique incisions for ACL reconstruction: Minimizing sensory deficit without compromising outcome.

Abstract

Aim: This randomized controlled trial aimed to evaluate the impact of different incision types (oblique, vertical, and horizontal) for hamstring graft harvest on sensory disturbances and functional outcomes after anterior cruciate ligament (ACL) reconstruction.

Methods: A total of 118 patients were randomized into three groups: oblique incision (n = 40), vertical incision (n = 40), and horizontal incision (n = 38). Sensory deficits were assessed using Von Frey Filaments at three weeks, three months, and six months postoperatively. Functional outcomes were measured using the International Knee Documentation Committee (IKDC) 2000 Subjective Knee Evaluation score at the 6-month mark. Statistical analyses included ANOVA and post-hoc tests to compare sensory disturbances across groups.

Results: At 6 months, the oblique incision group demonstrated significantly less sensory disturbance (34.7 mm² ± 38.6) than the vertical (43.8 mm² ± 39.1) and horizontal (63.4 mm² ± 42.4) incision groups (p = 0.031). No significant differences were found between the oblique and vertical incisions. The functional outcomes were comparable across all groups (P > 0.05).

Conclusion: Compared with vertical and horizontal incisions, oblique incisions for hamstring graft harvesting significantly reduced sensory disturbances without compromising functional outcomes. These findings suggest that careful selection of incision type can improve postoperative sensory outcomes in ACL reconstruction.