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前交叉韧带重建术后四个月的膝关节本体感觉:肢体优势、前外侧手术的影响以及与恢复运动准备状态的关联

Knee proprioception four months after anterior cruciate ligament reconstruction: Impact of limb dominance, anterolateral procedure, and association with readiness to return to sport.

作者信息

Drigny Joffrey, Rolland Marine, Remilly Marion, Guermont Henri, Reboursière Emmanuel, Hulet Christophe, Gauthier Antoine

机构信息

Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, Normandie Univ, UNICAEN, INSERM, COMETE, GIP CYCERON, 14000, Caen, France.

Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, 14000, Caen, France.

出版信息

Phys Ther Sport. 2025 Jan;71:61-68. doi: 10.1016/j.ptsp.2024.11.005. Epub 2024 Nov 22.

DOI:10.1016/j.ptsp.2024.11.005
PMID:39653012
Abstract

BACKGROUND

Knee proprioception may be compromised after anterior cruciate ligament reconstruction (ACLR), but associated factors and impact remain unclear. This study evaluated knee proprioception 4 months after primary ACLR, compared with healthy controls, and explored the impacts of leg dominance, anterolateral procedures (AEAPs), and their association with psychological readiness to return to sports.

METHODS

This prospective cohort study included 30 ACLR participants and 20 healthy controls. Isokinetic testing measured knee strength and proprioception, using passive joint position sense (JPS1: detection, JPS2: repositioning) and kinesthesia (threshold to detection of passive motion). At 8 months, ACLR participants completed the ACL-RSI scale to assess psychological readiness to return to sports.

RESULTS

At 4 months postoperative, kinesthesia was better in the operated limb than the non-operated limb (p = 0.008), but position sense did not differ significantly. There were no significant differences in kinesthesia or position sense between ACLR participants and controls. The operated limb had worse JPS2 if the ACLR was on the non-dominant side. Proprioception was unaffected by AEAPs, and only repositioning showed a moderate, non-significant correlation with ACL-RSI (r = -0.377).

CONCLUSION

At 4 months post-ACLR, kinesthesia improved in the operated leg; dominance influenced position sense, highlighting the need for personalized rehabilitation.

摘要

背景

前交叉韧带重建(ACLR)后膝关节本体感觉可能受损,但相关因素及影响尚不清楚。本研究评估了初次ACLR术后4个月时的膝关节本体感觉,并与健康对照组进行比较,同时探讨了肢体优势、前外侧手术(AEAPs)及其与恢复运动心理准备状态的关联。

方法

这项前瞻性队列研究纳入了30名ACLR参与者和20名健康对照者。采用等速测试测量膝关节力量和本体感觉,包括被动关节位置觉(JPS1:检测,JPS2:重新定位)和运动觉(被动运动检测阈值)。在术后8个月时,ACLR参与者完成ACL-RSI量表以评估恢复运动的心理准备状态。

结果

术后4个月时,患侧肢体的运动觉优于健侧肢体(p = 0.008),但位置觉无显著差异。ACLR参与者与对照组之间的运动觉或位置觉无显著差异。如果ACLR手术在非优势侧,患侧肢体的JPS2较差。本体感觉不受AEAPs影响,只有重新定位与ACL-RSI呈中度、非显著相关性(r = -0.377)。

结论

ACLR术后4个月时,患侧肢体的运动觉有所改善;肢体优势影响位置觉,凸显了个性化康复的必要性。

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