Oliver Gabriel, Portabella Federico, Hernandez Jose A
Orthopaedics Department, Hospital Universitari Bellvitge, Feixa Llarga, s/n, 08907, Barcelona, Spain.
Orthopaedics Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Eur J Orthop Surg Traumatol. 2019 Apr;29(3):633-638. doi: 10.1007/s00590-018-2334-4. Epub 2018 Oct 26.
Injury to the anterior cruciate ligament (ACL) not only causes mechanical instability but also produces proprioceptive deficit with an altered neuromuscular response. After ACL reconstruction, patients in general continue to complain of a feeling of knee instability. The objective of our study was to assess patient proprioception and its evolution over time by measuring the muscle latency time during a dynamic activity.
Twenty-five patients with an ACL tear following sports injuries were included in a prospective, comparative, matched controlled study. The study group consisted of the injured knees in those patients, while the control group consisted of the contralateral non-injured knee in the same patients. The neuromuscular response in five leg muscles (vastus medialis, vastus lateralis, rectus femoris, semitendinosus and biceps femoris) was measured during a dynamic activity through the muscle latency time via the use of electromyography.
The comparison of the reaction time in the vastus medialis showed that time in the injured knee was longer at pre-op, but it reduced over time reaching a value at 6 months post-op that was close to the reaction time in the non-injured knee group. In the rectus femoris, biceps femoris and semitendinosus muscles, the reaction times in the injured knee group were similar to those in the non-injured knee group at pre-op and post-op visits.
Before ACL surgery, the muscle latency time of the vastus medialis was significantly longer in the injured knee group than in the non-injured knee group. 'Muscle reflex reaction' as a response during a dynamic task improved in the ACL reconstructed patients at 6 months post-op.
Prospective, comparative, matched controlled study.
前交叉韧带（ACL）损伤不仅会导致机械性不稳定，还会产生本体感觉缺陷并改变神经肌肉反应。ACL重建术后，患者通常仍会抱怨膝关节不稳定感。我们研究的目的是通过测量动态活动期间的肌肉潜伏期来评估患者的本体感觉及其随时间的变化。
25例因运动损伤导致ACL撕裂的患者纳入一项前瞻性、比较性、匹配对照研究。研究组由这些患者的受伤膝关节组成，而对照组由同一患者的对侧未受伤膝关节组成。在动态活动期间，通过肌电图利用肌肉潜伏期测量五条腿部肌肉（股内侧肌、股外侧肌、股直肌、半腱肌和股二头肌）的神经肌肉反应。
股内侧肌反应时间的比较表明，受伤膝关节术前的时间较长，但随着时间推移而缩短，在术后6个月达到接近未受伤膝关节组反应时间的值。在股直肌、股二头肌和半腱肌中，受伤膝关节组术前和术后随访的反应时间与未受伤膝关节组相似。
在ACL手术前，受伤膝关节组股内侧肌的肌肉潜伏期明显长于未受伤膝关节组。在术后6个月，ACL重建患者在动态任务中的“肌肉反射反应”有所改善。
前瞻性、比较性、匹配对照研究。
