Carrera de Kinesiología, Departamento Ciencias de la salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Clínica MEDS, Santiago, Chile.
PLoS One. 2018 Nov 15;13(11):e0205658. doi: 10.1371/journal.pone.0205658. eCollection 2018.
The sensorimotor system helps to maintain functional joint stability during movement. After anterior cruciate ligament (ACL) injury and reconstruction, several sensorimotor deficits may arise, including altered proprioception and changes in neuromuscular control. It is still unknown whether the type of autograft used in the reconstruction may influence knee sensorimotor impairments. The aim of this study was to comparatively assess the effects of the hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) ACL reconstruction techniques on knee sensorimotor control 6-12 months post-operation. A total of 83 male subjects participated in this study: 27 healthy participants, 30 BPTB-operated patients and 26 HT-operated patients. Active joint position sense in 3 ranges of motion (90-60°, 60-30°, and 30-0° of knee flexion), isometric steadiness, and onset of muscle activation were used to compare sensorimotor system function between groups. Both operated groups had a small (< 5°) but significant joint position sense error in the 30-0° range when compared to the healthy group. No significant differences were found between the operated and the control groups for isometric steadiness or onset of muscle activation. The results of this study suggest that operated patients present knee proprioceptive deficits independently of surgical technique. Nevertheless, the clinical implications of this impairment are still unknown. It seems that selected surgical approach for ACL reconstruction do not affect functioning of the sensorimotor system to a large degree.
感觉运动系统有助于在运动过程中维持关节的功能性稳定性。前交叉韧带(ACL)损伤和重建后,可能会出现多种感觉运动缺陷,包括本体感觉改变和神经肌肉控制变化。用于重建的移植物类型是否会影响膝关节感觉运动损伤仍不清楚。本研究旨在比较腘绳肌腱(HT)和骨-髌腱-骨(BPTB)ACL 重建技术对术后 6-12 个月膝关节感觉运动控制的影响。共有 83 名男性受试者参与了这项研究:27 名健康参与者、30 名 BPTB 手术患者和 26 名 HT 手术患者。在 3 个运动范围(90-60°、60-30°和 30-0°的膝关节屈曲)中,主动关节位置感、等长稳定性和肌肉激活的起始用于比较组间感觉运动系统功能。与健康组相比,两组手术组在 30-0°范围内的关节位置感误差较小(<5°),但具有统计学意义。在等长稳定性或肌肉激活的起始方面,手术组与对照组之间没有发现显著差异。本研究结果表明,手术患者存在膝关节本体感觉缺陷,与手术技术无关。然而,这种损伤的临床意义仍不清楚。似乎 ACL 重建的选择手术方法不会在很大程度上影响感觉运动系统的功能。