Korean J Sports Med.  2012 Dec;30(2):100-109. 10.5763/kjsm.2012.30.2.100.

Proprioceptive and Knee Joint Kinematics for Comparison of Remnant Preserved versus Non-remnant Anterior Cruciate Ligament Reconstruction Using Achilles Allograft

• Kim KM
• Han JK
• Yi Y
• Chun CH

• KMID: 2288599
• DOI: http://doi.org/10.5763/kjsm.2012.30.2.100

Abstract

The purpose of remnant preserving technique in anterior cruciate ligament (ACL) reconstruction is to preserve mechanoreceptor and accelerate revascularization. In this study, we compared a group who underwent remnant preserving technique using Achilles tendon allograft with the other group of conventional ACL reconstruction in terms of proprioception, kinematic analysis, knee strength test and dynamic postural stability. Twenty-four patients were followed up for longer than 12 months after ACL reconstruction. They were separated into two groups; remnant preserving group (n=12) and non-remnant group (n=12). Proprioception test was conducted through joint position sense (JPS) and threshold to detection of passive motion. The remnant preserving group showed significantly less difference from the normal side than the non-remnant group. In kinematic analysis, there was statistically significant difference in peak flexion angle during the swing phase. However the 60degrees JPS, knee strength test, performance capacity test and dynamic postural stability did not showed the significant difference. Remnant preserving technique of ACL reconstruction was meaningful in preserving proprioception and the result showed akin to the unaffected gait.

Keyword

Anterior cruciate ligament; Remnant preserving technique; Proprioception

MeSH Terms

Achilles Tendon
Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Biomechanics
Gait
Humans
Joints
Knee
Knee Joint
Mechanoreceptors
Proprioception
Transplantation, Homologous

Figure

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  Fig. 1 Remnant preserving technique. (A) Femoral tunnel was positioned at the proximal part of bifurcate ridge preserving the remnant of anterior cruciate ligament (ACL). (B) Allograft was passed through beside the remnant of ACL. (C) Postoperative radiographs. *Remnant of ACL; †Achilles thedon allograft.

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  Fig. 2 The method of measured joint position sense. (A) Put on Lokomat (Hocoma AG). (B) Flow diagram for the measured joint position sense. The subject is placed into the target angle by the Lokomat and is asked to memorize the angle. After being moved away from the target, the subject move the leg back to the target angle.

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  Fig. 3 Primus-RS, BTE. Physical therapy equipment for multi-joint testing, orthopedic rehab, neuromuscular re-education, and advanced musculoskeletal athletic training of the upper & lower extremities and the core.

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  Fig. 4 Biodex Stability System (BSS, Biodex Medical Systems Inc.) Consists of a movable balance platform that provides up to 20° of surface tilt in a 360° range of motion. The platform is interfaced with computer software that enables the device to serve as an objective assessment of balance.

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  Fig. 5 Knee kinematics at average of each group. Group I was similar to the normal kinematics of the knee joint.

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