Korean J Sports Med.  2011 Dec;29(2):99-104. 10.5763/kjsm.2011.29.2.99.

Proprioceptive and Strength Comparison of Remnant Preserved versus Conventional Anterior Cruciate Ligament Reconstruction

• Kim DK
• Park WH

• KMID: 1987189
• DOI: http://doi.org/10.5763/kjsm.2011.29.2.99

Abstract

Reconstruction of the anterior cruciate ligament (ACL) restores knee stability. The remnant preserving technique was developed to preserve mechanoreceptor function, promote revasularzation and facilitate ligamentation. The purpose of this study was to analyze the clinical results of ACL reconstruction with remnant preserving. Between October in 2008 and September in 2009, 40 patients underwent ACL reconstruction using auto graft-hamstring tendon. On the basis of the ACL's condition patients were divided into 2 groups. In the trial group (preserved remnant group, PRG; n=20), there were 20 males with an average age of 26.2 years. In the control group (no remnant group, NRG; n=20) were 20 males with an average of age 27.1 years. We measured concentric peak torque of the knee extensors and flexors at 60degrees/s and 180degrees/s on an Isokinetic dynamometry. Proprioceptive functions have been assessed using Joint position sense and threshold to detection of passive motion. Dynamic postural stability was measured as a stability index in the anterior-posterior and medial-lateral planes with the Biodex Stability System. All tests were measured post-operative 1year. We found significant difference between the PRG and NRG for Joint position sense at 15degrees (2.40degrees+/-1.00degrees vs. 3.36degrees+/-0.95degrees; p=0.0145) and threshold to detect passive motion at 45degrees (2.02degrees+/-0.59degrees vs. 3.12degrees+/-0.94degrees; p=0.0213). But, we found no significant difference between the groups for the test results of the dynamic postural stability and knee strength. Therefore, preservation of the remnant ACL reconstruction is helpful in preserving the proprioception and function to stabilize the knee.

Keyword

Anterior cruciate ligament; Remnant preservation; Proprioception

MeSH Terms

Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Humans
Joints
Knee
Ligaments
Male
Mechanoreceptors
Proprioception
Tendons
Torque

Reference

References

1. Ageberg E. Consequences of a ligament injury on neuro-muscular function and relevance to rehabilitation-using the anterior cruciate ligament-injured knee as model. J Electromyogr Kinesiol. 2002; 12:205–12.

2. Childs SG. Pathogenesis of anterior cruciate ligament injury. Orthop Nurs. 2002; 21:35–40.

3. Barrett DS. Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg Br. 1991; 73:833–7.

4. Reider B, Arcand MA, Diehl LH, et al. Proprioception of the knee before and after anterior cruciate ligament reconstruction. Arthroscopy. 2003; 19:2–12.

5. Fremerey RW, Lobenhoffer P, Zeichen J, Skutek M, Bosch U, Tscherne H. Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament: a prospective, longitudinal study. J Bone Joint Surg Br. 2000; 82:801–6.

6. Kyung HS, Oh CW, Kim PT, Lee BW. Arthroscopic ACL reconstruction using quadrupled hamstring tendon with tibial remnant-preserving technique. J Korean Orthop Soc Sports Med. 2007; 6:92–8.

7. Lee BI, Kwon SW, Kim JB, Choi HS, Min KD. Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. Arthroscopy. 2008; 24:560–8.

8. Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y. The regeneration of sensory neurones in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 1999; 81:902–6.

9. Shimizu T, Takahashi T, Wada Y, Tanaka M, Morisawa Y, Yamamoto H. Regeneration process of mechanoreceptors in the reconstructed anterior cruciate ligament. Arch Orthop Trauma Surg. 1999; 119:405–9.

10. Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthop Scand. 2002; 73:330–4.

11. Park WH, Kim DK, Yoo JC, et al. Correlation between dynamic postural stability and muscle strength, anterior instability, and knee scale in anterior cruciate ligament deficient knees. Arch Orthop Trauma Surg. 2010; 130:1013–8.