Sensory Aspects of Knee Injuries

Detta är en avhandling från David Roberts, Ortopediska kliniken, USiL, 221 85 Lund, Sweden

Sammanfattning: Proprioceptive ability was estimated in different groups of patients with anterior cruciate ligament (ACL) injury as well as in different groups of healthy uninjured individuals. In study I, patients with poor outcome of the ACL injury – i.e. persistent symptoms of instability – were compared with patients with few symptoms after ACL injury, as well as with a control group. The results showed that the symptomatic patients had significantly poorer proprioception than the asymptomatic patients in some of the measurements. The symptomatic patients also had poorer proprioception than the control group, whereas no difference regarding proprioception was seen between the asymptomatic patient group and the control group. The proprioceptive ability after ACL reconstruction was measured in study II where a patient group was compared with a control group. The patients had significantly poorer proprioception in, not only their injured, reconstructed, knee but also in their uninjured knee, in some of the measurements. In study III, the influence on proprioception of injury pattern – i.e. associated injuries to menisci, collateral ligaments and cartilage – and other factors such as laxity, age and gender was examined. The results showed that cartilage defects, increased laxity and higher age were related to poorer proprioception whereas higher activity level before injury was related to better proprioception after injury. The effect of short-term exercise, ergometer cycling, on proprioception was examined in a group of healthy people in study IV. After cycling, poorer proprioception was found in 2 of 4 measurements. The influence on subjective and objective knee function of the factors a) proprioception b) strength (hamstring:quadriceps ratio) and c) laxity was analysed in study V. All these factors were found to significantly affect subjective or objective knee function. These results, described in Papers I-V, show that proprioception, in groups of individuals, may be affected by ACL injury and ACL reconstruction, may differ according to injury morphology, may be affected by short-term exercise and may be related to knee function. Proprioception must therefore be considered as a factor of importance when discussing treatment and rehabilitation of patients with ACL injuries.

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