Proprioception Analysis following Anterior Cruciate Ligament Reconstruction using Stabilometry: A Prospective, Longitudinal Study

Al-Dadah, Oday; Shepstone, Lee; Donell, Simon T.

doi:10.1055/s-0042-1758360

Accessibility / Report Error

Brazil

Revista Brasileira de Ortopedia

Português Español

Brazil

Português Español

table of contents « previous current next »

Table of contents

Original Article • Rev Bras Ortop 58 (3) • May-Jun 2023 • https://doi.org/10.1055/s-0042-1758360 copy

Proprioception Analysis following Anterior Cruciate Ligament Reconstruction using Stabilometry: A Prospective, Longitudinal Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Commonly used methods for measuring proprioception have resulted in conflicting reports regarding knee proprioception with anterior cruciate ligament (ACL) rupture and the influence of ACL reconstruction.

Methods

One hundred subjects (50 patients with radiologically and arthroscopically confirmed unilateral ACL rupture and 50 normal controls) were assessed with regards to proprioception using dynamic single-leg stance postural stabilometry. Instrumented knee ligament laxity and knee outcome scores were also measured. Of the 50 patients in the ACL group, 34 underwent reconstruction and were reassessed postoperatively.

Results

There was a significant proprioceptive deficiency in the ACL group compared with their contralateral knee ( p < 0.001) and to the control group ( p = 0.01). There was asignificant improvement in knee proprioception following ACL reconstruction compared to preoperative findings ( p = 0.003). There was no correlation between ligament laxity measurements and outcome scores. A significant correlation was found preoperatively between outcome scores and proprioception measurements. This correlation was not found post-operatively. Pre-operative proprioception testing had asignificant correlation (r = 0.46) with post-operative proprioception ( p = 0.006).

Conclusion

Patients with an ACL rupture had a proprioceptive deficit which improved following ligament reconstruction. Knee outcome scores had a better correlation with proprioception than ligament laxity. Proprioception may be a superior objective measure than ligament laxity in quantifying functional knee deficits and outcomes in patients with ACL ruptures. Level of Evidence III Therapeutic Study; Prospective Longitudinal Case-Control Study.

anterior cruciate ligament; mechanoreceptors; proprioception; stabilometry; knee ligament laxity; knee outcome scores

	ACL group	Control group
	(n = 50)	(n = 50)
Mean age (yrs) (SD)	30 (9)	25(5)
Male: female	36:14	35:15
Injured knee (right: left)	24:26	—
Mean height (m) (SD)	1.72 (0.1)	1.75 (0.1)
Mean weight (kg) (SD)	78.1 (14.4)	76.1 (14.4)
Mean BMI* (kg/m ² ) (SD)	26.2 (3.8)	24.6 (3.4)

Group	Mean (SD)
ACL group preoperatively (n = 49)
Injured knee	0.70 (0.45)
Uninjured knee	0.46 (0.35)
ACL Group postoperatively (n = 34)
Injured knee	0.47 (0.40)
Uninjured knee	0.42 (0.39)
Control group (n = 50)
Right knee	0.49 (0.35)
Left knee	0.52 (0.34)

	Uninjured knee ^a	Control group ^b	Injured knee postop ^a
	p -value (95%CI)	p -value (95%CI)	p -value (95%CI)
Lachman
Injured knee preop.	< 0.001* (4.6, 6.2)	< 0.001* (5.2, 7.3)	< 0.001* (1.0, 2.5)
Injured knee postop.	< 0.001* (1.4, 3.1)	< 0.001* (3.7, 5.4)	—
Anterior Drawer
Injured knee preop.	< 0.001* (4.3, 5.8)	< 0.001* (5.4, 7.8)	0.001* (0.9, 3.3)
Injured knee postop.	< 0.001* (1.5, 3.1)	< 0.001* (3.4, 5.2)	—

	Preoperative	Postoperative	p -value ^a (95% CI)
	Mean (SD)	Mean (SD)
Lysholm	71.7 (12.8)	85.3 (10.5)	< 0.001 (8,18-19,18)
Tegner	3.3(1.2)	4.1 (0.2)	0.006 (0,23-1,28)
	Preinjury	Postoperative
Tegner	6.7(1.3)	4.1 (0.2)	< 0.001 (2,11-3,31)

	Uninjured knee ^a	Control group ^b	Injured knee postop ^a
	p-value (95%CI)	p-value (95%CI)	p-value (95%CI)
Injured knee preop.	< 0.001* (0.14, 0.34)	0.01* (0.05, 0.38)	0.003* (0.10, 0.42)
Uninjured knee		0.73 (-0.16, 0.12)	-
Injured knee postop.	0.25 (-0.03, 0.13)	0.85 (-0.18, 0.15)	-

	Preoperative			Postoperative
	Log (OSI)	Lachman	Anterior drawer	log (OSI)	Lachman	Anterior drawer
	r/ p-value ^a	r/ p-value ^a	r/ p-value ^a	r/ p-value ^a	r/ p-value ^a	r/ p-value ^a
	95% CI	95% CI	95% CI	95% CI	95% CI	95% CI
Lachman	0.07 / 0.630	--	--	-0.24 / 0.180	--	--
	(-0.22, 0.34)			(-0.53, 0.11)
Anterior drawer	-0.07 / 0.640	--	--	0.09 / 0.620	--	--
	(-0.34, 0.22)			(-0.26, 0.42)
Tegner	-0.42 / 0.003*	0.02 / 0.890	0.13 / 0.370	-0.12 / 0.500	-0.19 / 0.2900	-0.15 / 0.4200
	(-0.63, -0.16)	(-0.27, 0.30)	(-0.16, 0.40)	(-0.44, 0.23)	(-0.50, 0.16)	(-0.46, 0.20)
Lysholm	-0.35 / 0.016*	-0.25 / 0.090	-0.20 / 0.180	-0.09 / 0.610	-0.22 / 0.230	-0.02 / 0.920
	(-0.58, -0.07)	(-0.50, 0.04)	(-0.46, 0.09)	(-0.42, 0.26)	(-0.52, 0.13)	(-0.36, 0.32)

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

Stay informed of issues for this journal through your RSS reader

[1] Address for correspondence Oday Al-Dadah, MBChB, FRCS(Eng), MD, FRCS (Tr & Orth), Consultant Orthopaedic Surgeon and Honorary Clinical Senior Lecturer, Newcastle University, Translational and Clinical Research Institute, Framlington Place, Newcastle-upon-Tyne, Tyne and Wear NE2 4HH, United Kingdom (e-mail: odayaldadah@hotmail.com).