Anterior Cruciate Ligament Mechanoreceptors Regeneration Following Reconstruction Using Autografts

Angoules, Antonios G

doi:10.4172/2161-0673.100e136

Cited by 1 publication

(2 citation statements)

References 32 publications

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“…Both in vivo animal [149,152] and human [153][154][155] studies have identified likely permanent protective neuromuscular reflex impairments over varying time periods following ACL reconstruction. These deficiencies may be primarily due to cortical sensorimotor impairments rather than the complete absence of ACL-neuromuscular reflexes [47,149,153].…”

Section: The Path To Improved Future Patient Outcomesmentioning

confidence: 99%

“…Limited evidence suggests that ACL reconstruction and rehabilitation effectively restores neurosensory or neuromuscular function to premorbid levels [47, 48]. Associated with this, knee OA rates remain high [19, 21], and less than optimal outcomes exist for patients who desire to participate in intense athletic activities [16, 18, 39, 49, 50].…”

Section: Introductionmentioning

confidence: 99%

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Permanent knee sensorimotor system changes following ACL injury and surgery

Nyland

Gamble

Franklin

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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The cruciate ligaments are components of the knee capsuloligamentous system providing vital neurosensory and biomechanical function. Since most historical primary ACL repair attempts were unsuccessful, reconstruction has become the preferred surgery. However, an increased understanding of the efficacy of lesion-site scaffolding, innovative suturing methods and materials, and evolving use of biological healing mediators such as platelet-rich plasma and stem cells has prompted reconsideration of what was once believed to be impossible. A growing number of in vivo animal studies and prospective clinical studies are providing increasing support for this intervention. The significance of ACL repair rather than reconstruction is that it more likely preserves the native neurosensory system, entheses, and ACL footprints. Tissue preservation combined with restored biomechanical function increases the likelihood for premorbid neuromuscular control system and dynamic knee stability recovery. This recovery should increase the potential for more patients to safely return to sports at their desired intensity and frequency. This current concepts paper revisits cruciate ligament neurosensory and neurovascular anatomy from the perspective of knee capsuloligamentous system function. Peripheral and central nerve pathways and central cortical representation mapping are also discussed. Surgical restoration of a more physiologically sound knee joint may be essential to solving the osteoarthritis dilemma. Innovative rehabilitative strategies and outcome measurement methodologies using more holistic and clinically relevant measurements that closely link biomechanical and neurosensory characteristics of physiological ACL function are discussed. Greater consideration of task-specific patient physical function and psychobehavioral links should better delineate the true efficacy of all ACL surgical and non-surgical interventions. Level of evidence IV.

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