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Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament

A PROSPECTIVE, LONGITUDINAL STUDY

R. W. Fremerey, MD, Trauma Surgeon; P. Lobenhoffer, MD, Trauma Surgeon; J. Zeichen, MD, Trauma Surgeon; M. Skutek, MD, Trauma Surgeon; U. Bosch, MD, Trauma Surgeon; and H. Tscherne, MD, Professor

Trauma Department, Hannover Medical School, Carl-Neuberg Strasse 1, D-30625 Hannover, Germany.

Correspondence should be sent to Dr R. W. Fremerey.

We assessed proprioception in the knee using the angle reproduction test in 20 healthy volunteers, ten patients with acute anterior instability and 20 patients with chronic anterior instability after reconstruction of the anterior cruciate ligament (ACL). In addition, the Lysholm-knee score, ligament laxity and patient satisfaction were determined.

Acute trauma causes extensive damage to proprioception which is not restored by rehabilitation alone. Three months after operation, there remained a slight decrease in proprioception compared with the preoperative recordings, but six months after reconstruction, restoration of proprioception was seen near full extension and full flexion. In the mid-range position, proprioception was not restored. At follow-up, 3.7 ± 0.3 years after reconstruction, there was further improvement of proprioception in the mid-range position. There was no difference between open and arthroscopic techniques. The highest correlation was found between proprioception and patient satisfaction. After reconstruction of the ACL reduced proprioception may explain the poor functional outcome in some patients, despite restoration of mechanical stability.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General