Factors affecting proprioceptive recovery after anterior cruciate ligament reconstruction

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Author:
ZHOU Mou-wang(Department of Rehabilitation Medicine Peking University Third Hospital,Beijing 100191,China)
GU Li(Department of Rehabilitation Medicine Peking University Third Hospital,Beijing 100191,China)
CHEN Ya-ping(Department of Rehabilitation Medicine Peking University Third Hospital,Beijing 100191,China)
YU Chang-long(Department of Sports Medicine Peking University Third Hospital,Beijing 100191,China)
AO Ying-fang(Department of Sports Medicine Peking University Third Hospital,Beijing 100191,China)
HUANG Hong-shi(Department of Rehabilitation Medicine Peking University Third Hospital,Beijing 100191,China)
YANG Yan-yan(Department of Rehabilitation Medicine Peking University Third Hospital,Beijing 100191,China)
Journal Title:
CHINESE MEDICAL JOURNAL
Issue:
Volume 121, Issue 22, 2008
DOI:
Key Word:
anterior cruciate ligament reconstruction;proprioception;muscle strength

Abstract: Background Proprioception plays an important role in knee movements.Since there are controversies surrounding the overall recovery time of proprioception following surgery,it is necessary to define the factors affecting proprioceptive recovery after anterior cruciate ligament (ACL) reconstruction and to investigate the relationship between proprioception and muscle strength.Methods A total of 36 patients who had their ACL reconstructed with a semitendinosus/gracilis graft (reconstructed group:6 months post-surgery) and 13 healthy adults without any knee injury (control group) were included in the study.Knee proprioception was evaluated with a passive reproduction test.Isokinetic strength was measured using the Biodex System.Statistical analysis was used to compare proprioception of the reconstructed group versus the control group,and to define causal factors,including sex,hamstring/quadriceps ratio,and the course of injury before reconstruction.We also investigated the correlation between the passive reproduction error and quadriceps index.Results There was a significant difference in proprioception between the reconstructed and control groups (P <0.05).When the course of injury before reconstruction was less than 4 months,there was a linear correlation with proprioception 6 months after the operation (r=0.713,P <0.05).There was a positive correlation between post-surgery proprioception and the quadriceps index at 6 months post-surgery.Conclusions Impaired knee proprioception is observed 6 months after ACL reconstruction.Within 4 months of injury,early undertaking of reconstruction is associated with better proprioception outcome.Patients with enhanced proprioception have a better quadriceps index.

  • [1]Krogsgaard MR,Dyhre-Poulsen P,Fischer-Rasmussen T.Cruciate ligament reflexes.J Electromyogr Kinesiol 2002;12:177-182.
  • [2]Park HB,Koh M,Cho SH,Hutchinson B,Lee B.Mapping the rat somatosensory pathway from the anterior cruciate ligament nerve endings to the cerebrum.J Orthop Res 2005;23:1419-1424.
  • [3]Reider B,Arcand MA,Diehl LH,Mroczek K,Abulencia A,Stroud CC,et al.Proprioception of the knee before and after anterior cruciate ligament reconstruction.Arthroscopy 2003;19:2-12.
  • [4]Bonfim TR,Jansen Paceola CA,Barela JA.Proprioceptive and behavior impairments in individuals with anterior cruciate ligament reconstructed knees.Arch Phys Med Rehabil 2003;84:1217-1223.
  • [5]Hopper DM,Creagh MJ,Forrnby PA,Goh SC,Boyle JJ,Strauss GR.Functional measurement of knee joint position sense after anterior cruciate ligament reconstruction.Arch Phys Med Rehabil 2003;84:868-872.
  • [6]Roberts D,Fridén T,Stomberg A,Lindstrand A,Moritz U.Bilateral proprioceptive defects in patients with a unilateral anterior cruciate ligament reconstruction:a comparison between patients and healthy individuals.J Orthop Res 2000;18:565-571.
  • [7]Aydo(g) ST,Korkusuz P,Doral MN,Tetik O,Demirel HA.Decrease in the numbers of mechanoreeeptors in rabbit ACL:the effects of ageing.Knee Surg Sports Traumatol Arthrosc 2006;14:325-329.
  • [8]Fridén T,Roberts D,Z(a)tterstr(o)m R,Lindstrand A,Moritz U.Proprioception in the nearly extended knee.Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients.Knee Surg Sports Traumatol Arthrosc 1996;4:217-224
  • [9]Lephart SM,Giraldo JL,Borsa PA,Fu FH.Knee joint proprioception:a comparison between female intercollegiate gymnasts and controls.Knee Surg Sports Traumatol Arthrosc 1996;4:121-124.
  • [10]Kobayashi A,Higuchi H,Terauchi M,Kobayashi F,Kimura M,Takagishi K.Muscle performance after anterior cruciate ligament reconstruction.Int Orthop 2004;28:48-51.
  • [11]Kynsburg A,Halasi T,Tallay A,Berkes I.Changes in joint position sense after conservatively treated chronic lateral ankle instability.Knee Surg Sports Traumatol Arthrosc 2006;14:1299-1306.
  • [12]Bennell K,Wee E,Crossley K,Stillman B,Hodges P.Effects of experimentally-induced anterior knee pain on knee joint position sense in healthy individuals.J Orthop Res 2005;23:46-53.
  • [13]Brunetti O,Filippi GM,Lorenzini M,Liti A,Panichi R,Roscini M,et al.Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction.Knee Surg Sports Traumatol Arthrosc 2006;14:1180-1187.
  • [14]Oksendahl HL,Fleming BC,Blanpied PR,Ritter M,Hulstyn MJ,Fadale PD.Intra-articular anesthesia and knee muscle response.Clin Biomech (Bristol,Avon) 2007;22:529-536.
  • [15]Steinbeck J,Brüntrup J,Greshake O,P(o)tzl W,Filler T,Liljenqvist U.Neurohistological examination of the inferior glenohumeral ligament of the shoulder.J Orthop Res 2003;21:250-255.
  • [16]Selfe J,Callaghan M,McHenry A,Richards J,Oldham J.An investigation into the effect of number of trials during proprioceptive testing in patients with patellofemoral pain syndrome.J Orthop Res 2006;24:1218-1224.
  • [17]Roberts D,Ageberg E,Andersson G,Fridén T.Effects of short-term cycling on knee joint proprioception in ACL-deficient patients.Knee Surg Sports Traumatol Arthrosc 2004;12:357-363.
  • [18]Bou(e)t V,Gahéry Y.Muscular exercise improves knee position sense in humans.Neurosci Lett 2000;289:143-146.
  • [19]Chmielewski TL,Hurd WJ,Rudolph KS,Axe MJ,Snyder-Mackler L.Perturbation training improves knee kinematics and reduces muscle co-contraction after complete unilateral anterior cruciate ligament rupture.Phys Ther 2005;85:740-749.
  • [20]Hurd WJ,Chmielewski TL,Snyder-Mackler L.Perturbation-enhanced neuromuscular training alters muscle activity in female athletes,Knee Surg Sports Traumatol Arthrosc 2006;14:60-69.
  • [21]Denti M,Monteleone M,Berardi A,Panni AS.Anterior cruciate ligament mechanoreceptors.Histologic studies on lesions and reconstruction.Clin Orthop Relat Res 1994;308:29-32.
  • [22]Huang HS,Zhou MW.The progress in proprioception rehabilitation of knee joint.Chin J Rehabil Med (Chin) 2003;18:567-569,
  • [23]Marcacci M,Zaffagnini S,Iacono F,Neri MP,Loreti I,Petitto A.Arthroscopic intra-and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons.Knee Surg Sports Traumatol Arthrosc 1998;6:68-75.
  • [24]Liu-Ambrose T,Taunton JE,MacIntyre D,McConkey P,Khan KM.The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee:a randomized clinical trial.Scand J Med Sci Sports 2003;13:115-123.
  • [25]Ageberg E.Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation-using the anterior eruciate ligament-injured knee as model.J Electromyogr Kinesiol 2002;12:205-212.
  • [26]Friemert B,Bach C,Schwarz W,Gemgross H,Schmidt R.Benefits of active motion for joint position sense.Knee Surg Sports Traumatol Arthrosc 2006;14:564-570.
  • [27]Salmon L,Russell V,Musgrove T,Pinczewski L,Refshauge K.Incidence and risk factors for graft rupture and contralateral rupture after anterior eruciate ligament reconstruction.Arthroscopy 2005;21:948-957.
  • [28]Roberts D,Ageberg E,Andersson G,Friden T.Clinical measurements of proprioception,muscle strength and laxity in relation to function in the ACL-injured knee.Knee Surg Sports Traumatol Arthrosc 2007;15:9-16.
  • [29]Katayama M,Higuchi H,Kimura M,Kobayashi A,Hatayama K,Terauchi M,et al.Proprioception and performance after anterior cruciate ligament rupture.Int Orthop 2004;28:278-281.
  • [30]Chandrashekar N,Mansouri H,Slauterbeck J,Hashemi J.Sex-based differences in the tensile properties of the human anterior cruciate ligament.J Biomech 2006;39:2943-2950.
  • [31]Schmitz RJ,Kulas AS,Perrin DH,Riemann BL,Shultz SJ.Sex differences in lower extremity biomechanics during single leg landings.Clin Biomech (Bristol,Avon) 2007;22:681-688.
  • [32]Borotikar BS,Newcomer R,Koppes R,McLean SG.Combined effects of fatigue and decision making on female lower limb landing postures:central and peripheral contributions to ACL injury risk.Clin Biomech (Bristol,Avon)2008;23:81-92.
  • [33]Meighan AA,Keating JF,Will E.Outcome after reconstruction of the anterior eruciate ligament in athletic patients.A comparison of early versus delayed surgery.J Bone Joint Surg Br 2003;85:521-524.
  • [34]Wu Y.Muscle test.In:Qu MY,Yu CL,eds.Practical sports medicine.Beijing:Beijing University Medical Press;2003:986-988.
  • [35]Keays SL,Bullock-Saxtona J,Keays AC,Newcombe P.Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis.Knee 2001;8:229-234.
  • [36]Konishi Y,Fukubayashi T,Takeshita D.Mechanism of quadriceps femoris muscle weakness in patients with anterior cruciate ligament reconstruction.Scand J Med Sci Sports 2002;12:371-375.
  • [37]Chmielewski TL,Stackhonse S,Axe MJ,Snyder-Mackler L.A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament rupture.J Orthop Res 2004;22:925-930.
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