Büyükafşar Enes, Başar Selda, Kanatli Ulunay
Department of Physical Therapy and Rehabilitation, Ahi Evran University, Kirşehir, Turkey.
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey.
J Knee Surg. 2020 Jul;33(7):722-727. doi: 10.1055/s-0039-1684010. Epub 2019 Apr 8.
After the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position sense (AJPS) method using digital inclinometer. Proprioception deviation angle was found to be higher in the operated leg at 30° and 60° flexion angles in the patient group compared with the other leg ( < 0.05), the biggest proprioception difference was between the 15° and 60° flexion angles in both the patient and the control group ( < 0.05) that the difference between 15° and 30° flexion angles is lowest ( < 0.05), and that these differences are higher in the operated leg of the patient group compared with the other leg of the patient group and to the dominant leg of the control group ( < 0.05). As approximately 4 years after ACL reconstruction with tibialis anterior tendon allograft, loss of proprioception at 60° knee flexion continued, ACL injury related to loss of proprioception may occur at angles higher than 30° flexion. Thus, patients may be provided with proprioception-enhancing rehabilitation in the long term, particularly, at flexion angles above medium levels.
在前交叉韧带(ACL)重建术后,会观察到本体感觉丧失,且这种情况在术后数年仍可能持续。本研究的目的是评估接受自体胫骨前肌腱ACL重建术的患者在不同膝关节屈曲角度站立位时的本体感觉。该研究纳入了34例接受自体胫骨前肌腱ACL重建术的患者和34名健康个体。使用数字倾角仪通过主动关节位置觉(AJPS)方法在15°、30°、60°屈曲角度的站立位评估本体感觉。结果发现,与健侧相比,患者组患侧在30°和60°屈曲角度时的本体感觉偏差角更高(<0.05);患者组和对照组中,15°与60°屈曲角度之间的本体感觉差异最大(<0.05),15°与30°屈曲角度之间的差异最小(<0.05),且患者组患侧的这些差异高于患者组健侧以及对照组优势侧(<0.05)。在自体胫骨前肌腱ACL重建术后约4年时,60°膝关节屈曲时的本体感觉丧失仍持续存在,与本体感觉丧失相关的ACL损伤可能发生在屈曲角度高于30°时。因此,长期来看,尤其是在中等以上屈曲角度时,可为患者提供增强本体感觉的康复训练。