Proprioceptive changes in the contralateral knee joint following anterior cruciate injury
There is loss of both stability and proprioception in the knee following an injury to the anterior cruciate ligament (ACL).The afferent nerves responsible for proprioception arise from the ligaments, capsule, surrounding mus- cles and skin, activating muscle contraction, which may be assumed to help stabilise the injuries, including ACL tears, are likely to disrupt this process. Loss of proprioception following an anterior cruciate ligament (ACL) injury has been well documented.
This study evaluated proprioception in both the injured and the uninjured limb in 25 patients with ACL injury and in 25 healthy controls, as assessed by joint position sense (JPS), the threshold for the detection of passive movement (TDPM) and postural sway during single-limb stance on a force plate. There were significant proprioceptive deficits in both ACL-deficient and uninjured knees compared with control knees, as assessed by the angle reproduction test (on JPS) and postural sway on single limb stance. The degree of loss of proprioception in the ACL-deficient knee and the unaffected contralateral knee joint in the same patient was similar. The TDPM in the injured knee was significantly higher than that of controls at 30° and 70° of flexion. The TDPM of the contralateral knee joint was not significantly different from that in controls.
In conclusion, this study shows that there is loss of proprioception in the knee following ACL injury. In patients with chronic ACL injury the proprioception in the contralateral ‘normal’ knee is less than that in healthy controls. Based on these findings, the effect of proprioceptive training of the contralateral uninjured knee should be explored. > From: Arockiaraj et al., Bone Joint J 95 (2013) 188–91.
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