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[Latest changes of joint proprioceptive function after posterior cruciate ligament reconstruction using double-bundle
Guiquan Han1, Shaofeng Wang, Wenming Luo
1Department of Orthopaedics, Affiliated Hospital of Weifang Medical College, Weifang Shandong, 261031, PR China.
Objective:
To explore latest changes of joint proprioceptive function after posterior cruciate ligament (PCL) reconstruction using double-bundle semitendinosus and gracilis under arthroscope.
Methods:
From June 2001 to November 2002, 25 patients with PCL ruptures were treated by arthroscope PCL reconstruction using double-bundle semitendinosus and gracilis, among whom 19 were males and 6 were females, aged 16-58 years old (36 on average). There were 6 cases of exercise injury, 15 of vehicle accident and 4 of falling injury. The duration before the operation was 1 week to 4 months (2.5 months on average). The posterior drawer test showed 23 patients were positive and 2 patients in the acute stage were not cooperative. MRI indicated that all the patients had PCL injuries. The proprioceptive function of the knee joints was (4.73 +/- 0.12) degrees before operation.
Results:
All patients' incisions obtained healing by first intention after the operation. The posterior drawer test showed that all the patients were negative. All 25 patients were followed up for 20-41 months (30.1 months on average). Eighteen months after operation, MRI indicated that bone marrow canal healed and internal fixation was stable. At the time of the last follow-up, the Lysholm score increased from (58.6 +/- 15.2) before operation to (93.2 +/- 7.4), and there was statistical difference (P < 0.05). The proprioceptive function of the knee joints was (5.67 +/- 0.32) degrees, (5.45 +/- 0.16) degrees, (3.80 +/- 0.01) degrees and (3.67 +/- 0.25) degrees at 5, 10, 15 and 20 months after operation, respectively. Statistical differences were observed between groups at 5, 10, 15, 20 months and the group before operation (P < 0.05). The proprioceptive function of the knee joints was (4.56 +/- 0.11) degrees at the final follow-up, and was significantly different from that of the normal knee joints was (2.13 +/- 0.41) degrees, (P < 0.05).
Conclusion:
Joint proprioceptive function decreases temporally after the arthroscopy PCL reconstruction and begins to restore 15 months after operation, and improves sharply 20 months after operation. All patients' Lysholm scores and symptoms improve after operation. Therefore, the operation is effective.
