Hypoesthesia after anterior cruciate ligament reconstruction: The relationship between proprioception and vibration perception deficits in individuals greater than one year post-surgery

Carol Ann Courtney*, Pranoti Atre, Kharma C. Foucher, Ali M. Alsouhibani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: While surgical reconstruction restores mechanical stability following anterior cruciate ligament (ACL) rupture, many experience early-onset osteoarthritis despite surgery. Neurophysiological changes are hypothesized to contribute to knee osteoarthritis progression. Proprioceptive deficits have been reported following ACL injury/reconstruction; however, vibration perception threshold (VPT) has been less studied. This study explored relationships between pain, VPT, proprioception, function, and strength following ACL-reconstruction. Methods: Twenty individuals (27 ± 6 years; 10 males) (standard deviation) status-post ACL-reconstruction were compared with a control group. Measurements included VPT, proprioception (threshold to detect passive movement), pain, function (Knee Outcome Survey (KOS)) and isometric quadriceps strength. Group differences were assessed using Mann-Whitney U tests, side-to-side differences with Wilcoxon Signed Rank tests, and associations evaluated using Spearman correlations. Results: The ACL-reconstruction group had minor functional deficits (15 ± 11%) and resting pain (1.8 ± 1.7). Impaired VPT and proprioception (hypoesthesia) were demonstrated on surgical compared to contralateral and control limbs (p ≤ 0.008). Proprioception was significantly different between contralateral and control knees, but not VPT. Surgical knee proprioceptive deficits and VPT deficits were positively correlated (ρ = 0.462, p = 0.047) but not in controls (ρ = −0.042, p = 0.862). Strength was negatively correlated to pain (ρ = −0.589; p = 0.006), but not to KOS scores, proprioception or VPT (p ≥ 0.099). Conclusion: Proprioceptive deficits following ACL injury have been ascribed to loss of afferent input from the torn ligament. Alternatively, multi-modality as well as contralateral sensory deficits suggest a spinal/supraspinal source of neurophysiological findings which may predispose to early osteoarthritis. Level of evidence: III.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalKnee
Volume26
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Knee
  • Neurophysiology
  • Postural control
  • Quantitative sensory testing
  • Surgery

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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