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同种异体移植物与自体移植物前交叉韧带重建的本体感觉比较。

Proprioceptive comparison of allograft and autograft anterior cruciate ligament reconstructions.

作者信息

Ozenci A Merter, Inanmaz Erkan, Ozcanli Haluk, Soyuncu Yetkin, Samanci Nehir, Dagseven Tufan, Balci Nilüfer, Gur Semih

机构信息

Department of Orthopaedics and Traumatology, Akdeniz University School of Medicine, 07070, Antalya, Turkey.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2007 Dec;15(12):1432-7. doi: 10.1007/s00167-007-0404-y. Epub 2007 Sep 9.

Abstract

The aim of this study is to search if there is any proprioceptive difference between auto and allograft anterior cruciate ligament (ACL) reconstructions, and also to determine if there is any relationship between instrumented anterior knee laxity and proprioception after an ACL reconstruction. The following four groups were constituted for this purpose: group I, control group; group II, autograft reconstructions; group III, allograft reconstructions and group IV, people with injured ACLs. Each group consisted of 20 patients/volunteers. Two subgroups were constituted according to the findings of KT-1,000 laxity testing in group II and III; patients/volunteers found to have a laxity of 3 mm or less were enrolled in the normal subgroup and those with a laxity of more than 3 mm were enrolled in the lax subgroup. Two proprioceptive tests were used: threshold to detect passive motion (TDPM) and joint position sense (JPS) by using Cybex Norm dynamometer. Patients underwent ten tests and the discrepancy in degrees was averaged for ten trials. Comparisons were made to evaluate the proprioceptive differences between groups/subgroups; ANOVA and t test was used for comparisons where appropriate, and the significance was set at P < 0.05. There was a significant difference in degrees between patients with injured ACLs and the other three groups in TDPM evaluations (injured: 1.93 degrees vs. control: 1.03 degrees , autograft: 1.01 degrees , allograft: 0.96 degrees ; P < 0.001). Auto and allograft reconstructions were not different from each other and controls. Allo and autograft ACL reconstructions are not different from each other according to proprioceptive measurements. Also, proprioception is not correlated to postoperative anterior knee laxity; many variables involve joint proprioception and mostly the anterior knee laxity may not be the sole determining element, and a lax ACL still may fulfill some of its afferent arc functions as long as it bridges the femur and tibia.

摘要

本研究的目的是探究自体与异体前交叉韧带(ACL)重建之间是否存在本体感觉差异,并确定ACL重建后仪器测量的膝关节前向松弛度与本体感觉之间是否存在关联。为此组建了以下四组:第一组,对照组;第二组,自体移植重建组;第三组,异体移植重建组;第四组,ACL损伤患者组。每组由20名患者/志愿者组成。根据第二组和第三组KT-1000松弛度测试结果组建了两个亚组;松弛度为3毫米或更小的患者/志愿者被纳入正常亚组,松弛度超过3毫米的患者/志愿者被纳入松弛亚组。使用了两种本体感觉测试:通过Cybex Norm测力计检测被动运动的阈值(TDPM)和关节位置觉(JPS)。患者接受十次测试,并将十次试验的度数差异进行平均。进行比较以评估组/亚组之间的本体感觉差异;在适当的情况下使用方差分析和t检验进行比较,显著性设定为P < 0.05。在TDPM评估中,ACL损伤患者与其他三组之间在度数上存在显著差异(损伤组:1.93度,对照组:1.03度,自体移植组:1.01度,异体移植组:0.96度;P < 0.001)。自体移植和异体移植重建彼此之间以及与对照组没有差异。根据本体感觉测量,异体和自体ACL重建彼此之间没有差异。此外,本体感觉与术后膝关节前向松弛度无关;许多变量涉及关节本体感觉,并且大多数情况下膝关节前向松弛度可能不是唯一的决定因素,只要ACL在股骨和胫骨之间起连接作用,松弛的ACL仍可能发挥其部分传入弧功能。

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