Objective To analyze the effect of the posterior cruciate ligament (PCL) retaining or not on knee-joint proprioception by comparing the proprioceptive difference between PCL retaining and no PCL retaining in total knee arthroplasty (TKA). Methods Between June 2009 and June 2010, 38 osteoarthritis patients meeting the inclusion criteria were divided into PCL retaining group (group A, n=19) and PCL-substituting group (group B, n=19) according to the random number table. There was no significant difference in gender, age, disease duration, the range of motion of the knee between 2 groups (P gt; 0.05). The effectiveness and the knee-joint proprioception were separately assessed by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score and the passive angle reproduction test (30, 60, and 90° of knee flexion) preoperatively and 12 months postoperatively. Results All incisons healed by first intention, without complications of infection, fracture, and deep vein thrombosis of lower limb. The patients were followed up 12-17 months (mean, 14.1 months). The knee function after operation was obviously improved when compared with preoperative one; significant differences were observed in the WOMAC scores and the results of passive angle reproduction test between at preoperation and at 12 months after operation (P lt; 0.05), but no significant difference was found between group A and group B (P gt; 0.05). Conclusion Whether PCL retaining or not in TKA both can improve knee-joint proprioception, and no obvious difference between them.
ObjectiveTo compare the recovery of proprioception of the knee after the anterior cruciate ligament (ACL) reconstruction with remnant preservation or not. MethodsBetween 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. ResultsAll 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). ConclusionACL reconstruction with remnant preservation is helpful for recovery of proprioception in knee joint at early stage.
ObjectiveTo study the effect of arthroscopic intercondylar fossa angioplasty on the ability of neuromuscular control of the knee joint in elderly patients with knee osteoarthritis (KOA). MethodsBetween June 2012 and March 2013, 20 elderly patients with KOA and in accordance with inclusion and exclusion criteria underwent arthroscopic intercondylar fossa angioplasty (operation group), and 20 healthy elderly people served as control group. There was no significant difference in age, height, weight, and body mass index between 2 groups (P>0.05). The proprioception capability (using passive regeneration test at measurement angles of 15, 30, and 60°) and quadriceps mobilization [including maximum voluntary contraction (MVC), central activation ratio (CAR), and activation deficit (AD)] were measured to avaluate the neuromuscular control of the knee;the Lysholm score was used to evaluate knee function. The above indexes were measured to assess the knee neuromuscular control and recovery of joint function in patients of operation group at 3, 6, and 9 months after operation. ResultsCompared with the control group, MVC, CAR, and Lysholm scores were significantly decreased, and the AD and passive knee angle difference were significantly increased in operation group (P<0.05) before operation. With the time after operation, the Lysholm score, CAR, and MVC increased gradually, and the AD and the passive knee angle difference decreased gradually. There was no significant difference in the indexes between 2 groups at 9 months after operation (P>0.05). ConclusionArthroscopic intercondylar fossa angioplasty can relieve ACL pressure, abrasion, and impact, which will recover the ability of neuromuscular control, increase proprioception and quadriceps mobilization capacity, and improve the joint function.