Barrett D S, Cobb A G, Bentley G
Royal National Orthopaedic Hospital, Stanmore, Middlesex, England.
J Bone Joint Surg Br. 1991 Jan;73(1):53-6. doi: 10.1302/0301-620X.73B1.1991775.
We measured joint position sense in the knee by a new method which tests the proprioceptive contribution of the joint capsule and ligaments. The leg was supported on a splint, and held in several positions of flexion. The subjects' perception of the position was recorded on a visual analogue model and compared with the actual angle of flexion. Eighty-one normal and 45 osteoarthritic knees were examined, as were 10 knees with semi-constrained and 11 with hinged joint replacements. All were assessed with and without an elastic bandage around the knee. There was a steady decline in joint position sense with age in subjects with normal knees. Those with osteoarthritic knees had impaired joint position sense at all ages (p less than 0.001). Knee replacement improved the joint position sense slightly (p less than 0.02); semi-constrained replacement had a greater effect than hinged replacement. The effect of an elastic bandage in subjects with poor position sense was dramatic, improving accuracy by 40% (p less than 0.001). It is proposed that reduced proprioception in elderly and osteoarthritic subjects may be responsible for initiation or advancement of degeneration of the knee.
我们采用一种新方法测量膝关节的关节位置觉，该方法可测试关节囊和韧带的本体感觉功能。将腿部置于夹板上，并保持在几个不同的屈曲位置。通过视觉模拟量表记录受试者对位置的感知，并与实际屈曲角度进行比较。共检查了81个正常膝关节、45个骨关节炎膝关节、10个半限制型膝关节置换术膝关节和11个铰链式膝关节置换术膝关节。所有膝关节在使用和不使用膝关节周围弹性绷带的情况下均进行了评估。正常膝关节受试者的关节位置觉随年龄增长而稳步下降。骨关节炎膝关节患者在各个年龄段的关节位置觉均受损（p<0.001）。膝关节置换术可轻微改善关节位置觉（p<0.02）；半限制型置换术的效果优于铰链式置换术。弹性绷带对位置觉较差的受试者效果显著，可将准确性提高40%（p<0.001）。研究表明，老年人和骨关节炎患者本体感觉减退可能是膝关节退变起始或进展的原因。
