Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
J Electromyogr Kinesiol. 1991 Sep;1(3):180-90. doi: 10.1016/1050-6411(91)90033-2.
Joint position sense has been suggested to be an important factor in the etiology of degenerative joint disease. It is also believed to be important in the rehabilitative process after reconstructive surgery of the knee. Despite this awareness, in many areas of orthopaedic surgery little effort has been devoted to study of this crucial topic. Therefore, we conducted several studies of knee joint position sense by measuring the ability of healthy subjects to reproduce an angle and detect the threshold of motion. Our goal was to evaluate the effects of the following factors: aging; degenerative joint disease; total knee replacement, i.e., both absence of the anterior cruciate ligament (ACL) and sensory loss due to the absence of capsular structures; fatigue; athletic training; disruption and reconstruction of the ACL; and the role of ligament mechanoreceptors. Our results show that normal individuals can actively reproduce an angle with their knee to an average error of 2.5°. Furthermore, normal subjects require passive movement of ∼2.5°-4° to detect a change in position at the speeds used in this study (∼0.5°/s). Muscular training improves the ability to detect motion. On the other hand, muscular training and fatigue appear to decrease the ability to reproduce an angle. Changes in the knee and its associated structures caused by damage (ACL disruption, arthritis, total knee replacement) as well as aging uniformly cause deterioration of joint position sense. Total knee replacement and arthritic change cause the greatest deterioration. Reconstruction of ligamentous structures and/or rehabilitation appears to restore joint position sense to a near normal level.
关节位置觉被认为是退行性关节疾病病因学中的一个重要因素。它在膝关节重建手术后的康复过程中也被认为是很重要的。尽管人们已经意识到了这一点，但在许多矫形外科领域，人们几乎没有努力研究这个关键课题。因此，我们通过测量健康受试者复制角度和检测运动阈值的能力，对膝关节位置觉进行了几项研究。我们的目标是评估以下因素的影响：年龄；退行性关节疾病；全膝关节置换术，即前交叉韧带（ACL）缺失和囊状结构缺失导致的感觉丧失；疲劳；运动训练；ACL 的中断和重建；以及韧带机械感受器的作用。我们的结果表明，正常个体可以主动将膝关节的角度复制到平均误差为 2.5°。此外，正常受试者需要被动移动约 2.5°-4°，以检测到在本研究中使用的速度（约 0.5°/s）下位置的变化。肌肉训练提高了检测运动的能力。另一方面，肌肉训练和疲劳似乎会降低复制角度的能力。损伤（ACL 中断、关节炎、全膝关节置换术）和衰老引起的膝关节及其相关结构的变化都会导致关节位置觉的恶化。全膝关节置换术和关节炎变化会导致最大程度的恶化。韧带结构的重建和/或康复似乎可以使关节位置觉恢复到接近正常的水平。
