Roberts D, Fridén T, Stomberg A, Lindstrand A, Moritz U
Department of Orthopedics, University Hospital Lund, Sweden.
J Orthop Res. 2000 Jul;18(4):565-71. doi: 10.1002/jor.1100180408.
Proprioception of the knee was measured in 20 patients with reconstructed anterior cruciate ligaments and in 19 age-matched controls. The mean time from surgery was 2 years. Three tests of proprioception were used: (a) threshold to detection of passive motion from 20 and 40 degrees toward flexion and extension, (b) active reproduction of a 30 degrees passive angle change, and (c) visual reproduction of a 30 degrees passive angle change. The aim was a complete, bilateral, proprioceptive evaluation of patients who had undergone reconstruction of the anterior cruciate ligament. As compared with those in the control group, the knees with reconstructed anterior cruciate ligaments had a higher threshold to detection of passive motion in the extension trials from 20 and 40 degrees (p = 0.0003 and 0.04, respectively) and in the flexion trials from 20 and 40 degrees (p = 0.004 and 0.0008, respectively). When the uninjured knees of the patients were compared with those in the control group, higher values for threshold to detection of passive motion were found in the flexion trials from 20 degrees (p = 0.002) and 40 degrees (p = 0.02). Thus, decreased proprioceptive ability was present in some measurements of these patients after reconstructive surgery, not only in injured knees but also in uninjured knees, as compared with the reference group. The functional relevance of these findings was not investigated in this study, but the results suggest that bilateral proprioceptive considerations should be made when evaluating prognostic factors, treatment, and risk of contralateral knee injury in patients with reconstructed anterior cruciate ligaments.
对20例前交叉韧带重建患者和19例年龄匹配的对照组进行了膝关节本体感觉测量。距手术的平均时间为2年。采用了三项本体感觉测试:(a) 检测从20度和40度向屈伸方向被动运动的阈值;(b) 主动重现30度的被动角度变化;(c) 视觉重现30度的被动角度变化。目的是对接受前交叉韧带重建的患者进行全面、双侧的本体感觉评估。与对照组相比,前交叉韧带重建的膝关节在从20度和40度伸展试验中检测被动运动的阈值更高(分别为p = 0.0003和0.04),在从20度和40度屈曲试验中也是如此(分别为p = 0.004和0.0008)。当将患者未受伤的膝关节与对照组进行比较时,发现在20度(p = 0.002)和40度(p = 0.02)的屈曲试验中,检测被动运动的阈值更高。因此,与参照组相比,这些患者在重建手术后的一些测量中存在本体感觉能力下降的情况,不仅在受伤的膝关节中,未受伤的膝关节中也是如此。本研究未调查这些发现的功能相关性,但结果表明,在评估前交叉韧带重建患者的预后因素、治疗和对侧膝关节损伤风险时,应考虑双侧本体感觉。