A COMPARISON OF PROPRIOCEPTIVE SENSIVITY OF THE KNEE FOLLOWING ACL RECONSTRUCTION USING FOUR STRAND HAMSTRINGS AND BONE PATELLAR TENDON BONE AUTOGRAFTS

Abstract

Purpose: To evaluate knee proprioception following Anterior Cruciate Ligament (ACL) reconstruction using two different autografts.

Materials and methods: Forty patients, (34 male, 6 female), aged between 17–54 years old (mean: 31), with complete ACL tears were subjected to ligamentous reconstruction. Group A (20 patients) underwent reconstruction with 4 strand hamstrings graft whilst in the remaining 20 patients (group B) bone-patellar tendon-bone graft was used. Proprioception was assessed by the Joint Position Sense (JPS) of the knee for predetermined angles (15°, 45° and 75°) as well as by the threshold to detection of passive movement (TTDPM) at 15° and 45° in flexion and extension using an isokinetic dynamometer (Con-Trex, MJ, Switzerland). The examination was performed pre-operatively and 3, 6 and 12 months after surgery, on both knees of all patients.

The t-test was utilised for statistical analysis.

Results: ACL deficient knees presented with significantly poor TTDPM values at a starting angle of 15° moving into flexion and extension. The JPS findings were statistically different between injured and uninjured knees (p< 0.05).

The TTDPM at 15° and JPS findings of the injured leg, before and 6, 12 months after reconstructive surgery, were statistically different (p< 0.05) for both groups.

There was no statistically significant difference for both JPS and TTDPM at 15° in flexion and extension between the findings in reconstructed and uninjured knees, at 6 and 12 months post-operatively in both groups.

No difference was found when comparing proprioceptive improvement following ACL reconstruction between the two different autograft groups.

Conclusions: Both JPS at 15°, 45°, and 75° and TTDPM at 15° in flexion and extension are impaired in ACL deficient knees. There is improvement of these proprioceptive parameters following operative reconstruction of the ACL using both hamstrings and patellar tendon grafts. No particular graft seems to be preferable in terms of proprioceptive improvement as assessed by JPS and TTDPM.