Department Orthopaedics and Rehabilitation, Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
Department Orthopaedics and Rehabilitation, Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA; Department of Mechanical Engineering, University of Vermont, Burlington, Vermont, USA; Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, Vermont, USA.
Knee. 2023 Jun;42:51-56. doi: 10.1016/j.knee.2023.02.008. Epub 2023 Mar 7.
Disruption of the anterior cruciate ligament (ACL) is associated with significant biomechanical and neuromuscular changes including deficits in joint proprioception. While previous studies have assessed joint position sense (JPS) in ACL deficient knees, methods have varied and few have done so with prospective study designs. The specific aim of this investigation was to determine the effect(s) of ACL reconstruction and recovery time may have on JPS.
In this prospective study, we assess the effects of ACL reconstruction and rehabilitation on joint position sense in a temporal study. Twelve patients with unilateral ACL injuries were assessed pre-operatively and at 2, 4, 8 months post-op. JPS measurements were performed, while the subject was standing, with passive-active (P-A) and active-active (A-A) tests. Comparisons between the injured/reconstructed and contralateral, uninjured knee were evaluated in terms of real and absolute mean errors.
There were no statistically significant differences between the injured/reconstructed and contralateral/normal side with P-A or A-A testing at 2, 4, or 8 months.
We conclude that there is no difference in joint position sense between the injured and contralateral leg after ACL disruption and reconstruction beginning as early as 2 months post-op. This study provides further evidence that knee proprioception is not altered by ACL injury and reconstruction.
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前交叉韧带（ACL）的断裂与显著的生物力学和神经肌肉变化有关，包括关节位置感知（JPS）的缺陷。虽然之前的研究已经评估了 ACL 缺陷膝关节的关节位置感觉（JPS），但方法各不相同，很少有前瞻性研究设计。本研究的具体目的是确定 ACL 重建和恢复时间对 JPS 的影响。
在这项前瞻性研究中，我们在时间研究中评估 ACL 重建和康复对关节位置感觉的影响。12 名单侧 ACL 损伤患者在术前和术后 2、4、8 个月进行评估。JPS 测量在患者站立时进行，分别进行被动-主动（P-A）和主动-主动（A-A）测试。比较受伤/重建侧与对侧未受伤膝关节的真实和绝对平均误差。
在 2、4 或 8 个月时，P-A 或 A-A 测试中，受伤/重建侧与对侧/正常侧之间没有统计学上的显著差异。
我们得出结论，ACL 断裂和重建后，受伤腿和对侧腿的关节位置感觉没有差异，早在术后 2 个月就开始出现这种情况。这项研究进一步证明，ACL 损伤和重建不会改变膝关节的本体感觉。
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