Okuda Kazuhiro, Abe Nobuhiro, Katayama Yoshimi, Senda Masuo, Kuroda Takayuki, Inoue Hajime
Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
J Orthop Sci. 2005 May;10(3):277-83. doi: 10.1007/s00776-005-0893-9.
Recent clinical studies have investigated postural sway characteristics in anterior cruciate ligament (ACL)-deficient knees, but the relative contributions of vision and ACL remain unclear. In the current study, we measured and compared postural sway during one-leg standing with eyes open and closed to assess the difference between legs with and without ACL injury, and we discuss the contribution of the ligament relative to vision and to postural sway in patients. We examined 32 patients (17 males, 15 females) with ACL injury before surgery from March 2001 through January 2004. None presented obvious dysfunction in the lower limbs or central nervous system. Using a gravicorder, we measured locus length per time (LG) and environmental area (AR) as the factors of postural sway during two-leg and one-leg standing with eyes open or closed. In the ACL-injured knee, the amount of postural sway increased significantly during injured leg standing with eyes closed (LG, P < 0.0001; AR, P < 0.0001), but it did not increase significantly with eyes open. There were no significant differences with respect to sex or general joint laxity. There was no correlation between postural sway and the anterior translation of the tibia measured by arthrometer KT2000 or between the muscle strength around the knee. We concluded that the amount of postural sway in the ACL-injured knee increased significantly on injured leg standing with eyes closed, and that vision appears to be dominant in compensating for the decreased contribution of the injured ACL.
近期的临床研究对前交叉韧带（ACL）损伤膝关节的姿势摆动特征进行了调查，但视觉和ACL的相对作用仍不明确。在本研究中，我们测量并比较了单腿站立时睁眼和闭眼状态下的姿势摆动，以评估ACL损伤腿和未损伤腿之间的差异，并探讨韧带相对于视觉以及对患者姿势摆动的作用。我们检查了2001年3月至2004年1月期间32例手术前ACL损伤的患者（17例男性，15例女性）。所有患者下肢或中枢神经系统均无明显功能障碍。使用重力记录仪，我们测量了双腿和单腿站立睁眼或闭眼时作为姿势摆动因素的每次轨迹长度（LG）和环境面积（AR）。在ACL损伤的膝关节中，患侧腿闭眼站立时姿势摆动量显著增加（LG，P < 0.0001；AR，P < 0.0001），但睁眼时未显著增加。在性别或一般关节松弛度方面无显著差异。姿势摆动与用KT2000关节测量仪测量的胫骨前移之间或与膝关节周围肌肉力量之间均无相关性。我们得出结论，ACL损伤膝关节在患侧腿闭眼站立时姿势摆动量显著增加，并且视觉似乎在补偿损伤的ACL贡献降低方面占主导地位。
