Temporal change of joint position sense after posterior cruciate ligament reconstruction using multi-stranded hamstring tendons

Abstract

A total of 29 patients who had undergone posterior cruciate ligament (PCL) reconstruction using multi-stranded hamstring tendons were prospectively followed-up for joint stability and proprioceptive function at a minimum of 24 months after surgery. We measured temporal changes of the posterior laxity by stress radiography and the KT-2000 arthrometer, and we also measured joint position sense for an average of 42 months (range 24-78 months). In terms of results, improvement of joint stability was observed postoperatively and maintained over 2 years after PCL reconstruction, although posterior stability in the reconstructed knee was not identical to the contralateral normal knee. Although joint position sense worsened just after reconstruction, it gradually recovered from 18 months after surgery. However, proprioceptive function after PCL reconstruction did not recover to the same level as in the contralateral normal knee even over 24 months after surgery.

Proprioception and Clinical Results of Anterolateral Single-Bundle Posterior Cruciate Ligament Reconstruction with Remnant Preservation

“…In our study, the TTDPM and RPP that were evaluated from two starting positions, 45° and 110°, after remnant-preserving PCL reconstruction were reduced in the PCL-deficient knees, but the side-to-side differences were statistically insignificant. In a study by Adachi et al28) on the joint position sense after PCL reconstruction, the authors reported that the joint position sense that had worsened immediately after reconstruction was gradually recovered from 18 months postoperatively to the preoperative level at 24 months postoperative. In our study, the proprioception of the injured knees became similar to that of the uninjured knees at the last follow-up, although the changes during the follow-up period were not assessed.…”

The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control

“…The main source of afferent information for JPS arises from muscle spindles, however mechanoreceptors in joint capsules and cutaneous tactile receptors may also contribute (for review see Gilman, 2002). Joint position sense has been extensively studied in the ankle, knee and hip joints (Adachi et al, 2007;Bennell et al, 2005;Beynnon et al, 2002;Hazneci et al, 2005;Hopper et al, 2003;Ishii et al, 1997;Karanjia and Ferguson, 1983;Larsen et al, 2005;Marks, 1996;Okuda et al, 2006;Reider et al, 2003;Ribeiro et al, 2007;Tsauo and Cheng, 2008), particularly to investigate the effects of reconstructive surgery (Adachi et al, 2007;Hopper et al, 2003;Reider et al, 2003), osteoarthritis (Barrett et al, 1991;Bennell et al, 2003;Marks, 1996), joint bracing (for review see Beynnon et al, 2002), and various exercise or re-training programs (Friemert et al, 2006;Hazneci et al, 2005;Ribeiro et al, 2007;Tsauo and Cheng, 2008). Recently there has also been an increased focus in the literature on spinal JPS (Allison, 2003;Jull et al, 2007;Learman et al, 2009;Strimpakos et al, 2006;Swinkels and Dolan, 1998), however, much less research has looked at the effect of the spine on limb JPS (Knox et al, 2006a,b;Knox and Hodges, 2005).…”

Allograft Versus Autograft in Posterior Cruciate Ligament Reconstruction: An Evidence-Based Systematic Review

“…The remaining 50 publications were excluded. Of the 19 included articles, 5 reported on allograft only, [13][14][15][16][17] 12 reported on autograft only, [18][19][20][21][22][23][24][25][26][27][28][29] and 2 directly compared the two graft types. 30,31 The total review cohort was comprised of 611 patients with an average follow-up of 44.4 months (►Tables 1-3).…”

“…A total of 12 studies using autograft for isolated PCL reconstruction in 368 patients met our inclusion criteria (►Table 2). [18][19][20][21][22][23][24][25][26][27][28][29] The average follow-up was 39.2 months (range: 24 to 66 months). The average age was 31 years (range: 16 to 60 years).…”

“…One study was of level I evidence, 26 one of level II, 22 three of level III, 21,25,28 and seven of level IV. [18][19][20]23,24,27,29 Graft sources included semitendinosus/ gracilis tendon (72%), bone-patellar tendon-bone (16%), and quadriceps tendon (12%). Outcome measures included a mean Lysholm score (11 studies, 357 patients) of 91.0 (range: 80 to 96.9) 18-22,24-29 and a mean Tegner score (8 studies, 236 patients) of 6.0 (range: 4.7 to 6.9).…”