TY - JOUR
T1 - Hypoesthesia after anterior cruciate ligament reconstruction
T2 - The relationship between proprioception and vibration perception deficits in individuals greater than one year post-surgery
AU - Courtney, Carol Ann
AU - Atre, Pranoti
AU - Foucher, Kharma C.
AU - Alsouhibani, Ali M.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Knee
KW - Neurophysiology
KW - Postural control
KW - Quantitative sensory testing
KW - Surgery
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UR - http://www.scopus.com/inward/citedby.url?scp=85057251921&partnerID=8YFLogxK
U2 - 10.1016/j.knee.2018.10.014
DO - 10.1016/j.knee.2018.10.014
M3 - Article
C2 - 30497806
AN - SCOPUS:85057251921
VL - 26
SP - 194
EP - 200
JO - Knee
JF - Knee
SN - 0968-0160
IS - 1
ER -