EFFECTIVENESS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH REMNANT PRESERVATION ON PROPRIOCEPTION RESTORATION OF KNEE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HEChuan ¹ ,  LIYanlin ¹ , LIXiaogang ² , WANGGuoliang ¹ , WANGJianwei ¹ , CAOShuhai ¹ , WANGHuijian ¹ , ZHAOFengkai ¹

1. Department of Sports Medicine, No.1.Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650101, P. R. China;
2. Department of Rehabilitation, Affiliated Hospital of Youjiang Medical University for Nationalities;

Corresponding?author：

LIYanlin, Email: 852387873@qq.com

Keywords：

Anterior cruciate ligament; Remnant preservation; Proprioception

DOI：

10.7507/1002-1892.20140101

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Objective To compare the recovery of proprioception of the knee after the anterior cruciate ligament (ACL) reconstruction with remnant preservation or not. Methods Between January 2010 and October 2012, 40 patients with ACL rupture were divided into remnant preservation reconstruction group (trial group, n=20) and traditional reconstruction group (control group, n=20). There was no significant difference in gender, age, disease duration, injury causes, preoperative Lysholm scores, and preoperative International Knee Documentation Committee (IKDC) scores between 2 groups (P>0.05). All the patients received ACL single-bundle reconstruction surgery with autologous hamstring tendon transplantation under arthroscope. After operation, the function of knee was assessed by Lysholm and IKDC scores and the proprioception was assessed by joint position sense (JPS) value which was evaluated by passive repeat angle test with isokinetic test system. Results All incisions healed by first intention in 2 groups. The patients were followed up 12-16 months (mean, 14.0 months) in trial group, and 12-15 months (mean, 14.5 months) in control group. At 12 months after operation, the Lysholm and IKDC scores were significantly increased when compared with preoperative scores (P<0.05) in both groups, but no significant difference was found between 2 groups (P>0.05). At 3 months and 12 months after operation in trial group, the JPS values of operated knee at 15, 45, and 75° of flexion were significantly lower than preoperative values (P<0.05), but no significant difference was found between at 3 months and at 12 months after operation (P>0.05). At 3 months after operation in control group, there was no significant difference (P>0.05) in JPS values of operated knee at 15, 45, and 75° of flexion when compared with preoperative ones; but at 12 months after operation in control group, the JPS values of operated knee at 15, 45, and 75° of flexion were significantly lower than those at preoperation and at 3 months after operation (P<0.05). At 3 months after operation, the JPS of operated knee at 15, 45, and 75° of flexion in trial group were significantly lower than those of operated knee in control group (P<0.05), but no significant difference was found between 2 groups at 12 months after operation (P>0.05). At 3 and 12 months after operation in trial group, there was no significant difference (P>0.05) in JPS values at 15, 45, and 75° of flexion between operated and normal knees; at 3 months after operation in control group, the JPS values of operated knee at 15, 45, and 75° of flexion were significantly higher than those of normal knee, but there was no significant difference between operated knee and normal knee at 12 months after operation (P>0.05). Conclusion ACL reconstruction with remnant preservation is helpful for recovery of proprioception in knee joint at early stage.

Citation： HEChuan, LIYanlin, LIXiaogang, WANGGuoliang, WANGJianwei, CAOShuhai, WANGHuijian, ZHAOFengkai. EFFECTIVENESS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH REMNANT PRESERVATION ON PROPRIOCEPTION RESTORATION OF KNEE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 442-447. doi: 10.7507/1002-1892.20140101 Copy

1.	Hong L, Li X, Zhang H, et al. Anterior cruciate ligament reconstruction with remnant preservation:a prospective, randomized controlled study. Am J Sports Med, 2012, 40(12):2747-2755.
2.	Ahn JH, Lee YS, Ha HC, et al. Anterior cruciate ligament reconstruction with preservation of remnant bundle using hamstring autograft:technical note. Arch Orthop Trauma Surg, 2009, 129(8):1011-1015.
3.	Jung YB, Jung HJ, Siti HT, et al. Comparison of anterior cruciate ligament reconstruction with preservation only versus remnant tensioning technique. Arthroscopy, 2011, 27(9):1252-1258.
4.	Maffiuletti NA, Bizzini M, Desbrosses K, et al. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer. Clin Physiol Funct Imaging, 2007, 27(6):346-353.
5.	Bastin J, Calvin S, Montagne G. Muscular proprioception contributes to the control of interceptive actions. J ExP Psychol Hum Percept Perform, 2006, 32(4):964-972.
6.	Grigg P. Contents peripheral neural mechanisms in proprioception. J Sport Rehab, 1994, 3(1):2-17.
7.	沙霖, 趙金忠. 前交叉韌帶脛骨側殘端中機械感受器的計數研究. 中國修復重建外科雜志, 2010, 24(11):1318-1322.
8.	Lee BI, Min KD, Choi HS, et al. Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees. Knee Surg Sports Traumatol Arthroc, 2009, 17(9):1095-1101.
9.	Katayama M, Higuchi H, Kimura M, et al. Proprioception and performance after anterior cruciate ligament rupture. Int Orthop, 2004, 28(5):278-281.
10.	Roberts D, Ageberg E, Andersson G, et al. Clinical measurements of proprioceptionmuscle strength and laxity in relation to function in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc, 2007, 15(1):9-16.
11.	Park SY, Oh H, Park SW, et al. Clinical outcomes of remnant-preserving augmentation versus double-bundle reconstruction in the anterior cruciate ligament reconstruction. Arthroscopy, 2012, 28(12):1833-1841.
12.	Fink C, Zapp M, Benedetto KP, et al. Tibial tunnel enlargement following anterior cruciate ligment reconstruction with patellar tendonautograft. Arthroscopy, 2001, 17(2):138-143.
13.	孫然, 陳百成, 王曉峰, 等. 前十字韌帶重建術后骨隧道擴大與臨床療效的關系. 中華骨科雜志, 2006, 26(4):256-260.
14.	Lee BI, Kwon SW, Kim JB, et al. Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. Arthroscopy, 2008, 24(5):560-568.
15.	Ahn JH, Wang JH, Lee YS, et al. Anterior crucaite ligament reconstruction using remnant preservation and a femoral tensioning technique:clinical and magnetic resonance imaging results. Arthroscopy, 2011, 27(8):1079-1089.
16.	Lee JH, Bae DK, Song SJ, et al. Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts. Arthroscopy, 2010, 26(1):41-49.
17.	李志超, 劉玉杰, 石斌, 等. 保留殘端纖維與剩余束重建前交叉韌帶的實驗研究. 中國修復重建外科雜志, 2009, 23(3):282-286.
18.	Adachi N, Ochi M, Uchio Y, et al. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta OrthoP Scand, 2002, 73(3):330-334.
19.	李濤. 前交叉韌帶與膝關節本體感覺關系的研究進展. 中國康復理論與實踐, 2012, 18(8):734-739.
20.	Lee BI, Min KD, Choi HS, et al. Arthroscopic anterior cruciate ligament reconstruction with the tibial-remnant preserving technique using a hamstring graft. Arthroscopy, 2006, 22(3):340. e1-7.
21.	Karasel S, Akpinar B, Gülbahar S, et al. Clinical and functional outcomes and proprioception after a modified accelerated rehabilitation program following anterior cruciate ligament reconstruction with patellar tendon autograft. Acta Orthop Traumatol Turc, 2010, 44(3):220-228.
22.	Moezy A, Olyaei G, Hadian M, et al. A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. Br J Sports Med, 2008, 42(5):373-385.

1. Hong L, Li X, Zhang H, et al. Anterior cruciate ligament reconstruction with remnant preservation:a prospective, randomized controlled study. Am J Sports Med, 2012, 40(12):2747-2755.
2. Ahn JH, Lee YS, Ha HC, et al. Anterior cruciate ligament reconstruction with preservation of remnant bundle using hamstring autograft:technical note. Arch Orthop Trauma Surg, 2009, 129(8):1011-1015.
3. Jung YB, Jung HJ, Siti HT, et al. Comparison of anterior cruciate ligament reconstruction with preservation only versus remnant tensioning technique. Arthroscopy, 2011, 27(9):1252-1258.
4. Maffiuletti NA, Bizzini M, Desbrosses K, et al. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer. Clin Physiol Funct Imaging, 2007, 27(6):346-353.
5. Bastin J, Calvin S, Montagne G. Muscular proprioception contributes to the control of interceptive actions. J ExP Psychol Hum Percept Perform, 2006, 32(4):964-972.
6. Grigg P. Contents peripheral neural mechanisms in proprioception. J Sport Rehab, 1994, 3(1):2-17.
7. 沙霖, 趙金忠. 前交叉韌帶脛骨側殘端中機械感受器的計數研究. 中國修復重建外科雜志, 2010, 24(11):1318-1322.
8. Lee BI, Min KD, Choi HS, et al. Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees. Knee Surg Sports Traumatol Arthroc, 2009, 17(9):1095-1101.
9. Katayama M, Higuchi H, Kimura M, et al. Proprioception and performance after anterior cruciate ligament rupture. Int Orthop, 2004, 28(5):278-281.
10. Roberts D, Ageberg E, Andersson G, et al. Clinical measurements of proprioceptionmuscle strength and laxity in relation to function in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc, 2007, 15(1):9-16.
11. Park SY, Oh H, Park SW, et al. Clinical outcomes of remnant-preserving augmentation versus double-bundle reconstruction in the anterior cruciate ligament reconstruction. Arthroscopy, 2012, 28(12):1833-1841.
12. Fink C, Zapp M, Benedetto KP, et al. Tibial tunnel enlargement following anterior cruciate ligment reconstruction with patellar tendonautograft. Arthroscopy, 2001, 17(2):138-143.
13. 孫然, 陳百成, 王曉峰, 等. 前十字韌帶重建術后骨隧道擴大與臨床療效的關系. 中華骨科雜志, 2006, 26(4):256-260.
14. Lee BI, Kwon SW, Kim JB, et al. Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. Arthroscopy, 2008, 24(5):560-568.
15. Ahn JH, Wang JH, Lee YS, et al. Anterior crucaite ligament reconstruction using remnant preservation and a femoral tensioning technique:clinical and magnetic resonance imaging results. Arthroscopy, 2011, 27(8):1079-1089.
16. Lee JH, Bae DK, Song SJ, et al. Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts. Arthroscopy, 2010, 26(1):41-49.
17. 李志超, 劉玉杰, 石斌, 等. 保留殘端纖維與剩余束重建前交叉韌帶的實驗研究. 中國修復重建外科雜志, 2009, 23(3):282-286.
18. Adachi N, Ochi M, Uchio Y, et al. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta OrthoP Scand, 2002, 73(3):330-334.
19. 李濤. 前交叉韌帶與膝關節本體感覺關系的研究進展. 中國康復理論與實踐, 2012, 18(8):734-739.
20. Lee BI, Min KD, Choi HS, et al. Arthroscopic anterior cruciate ligament reconstruction with the tibial-remnant preserving technique using a hamstring graft. Arthroscopy, 2006, 22(3):340. e1-7.
21. Karasel S, Akpinar B, Gülbahar S, et al. Clinical and functional outcomes and proprioception after a modified accelerated rehabilitation program following anterior cruciate ligament reconstruction with patellar tendon autograft. Acta Orthop Traumatol Turc, 2010, 44(3):220-228.
22. Moezy A, Olyaei G, Hadian M, et al. A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. Br J Sports Med, 2008, 42(5):373-385.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH REMNANT PRESERVATION ON PROPRIOCEPTION RESTORATION OF KNEE

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