Η ιδιοδεκτική αισθητικότητα μετά από ανακατασκευή του πρόσθιου χιαστού συνδέσμου με μόσχευμα επιγονατιδικού τένοντος με οστικά άκρα σε σύγκριση με αυτή μετά από χρήση μοσχεύματος ισχιοκνημιαίων και η επίδρασή της στο τελικό λειτουργικό αποτέλεσμα

Abstract

Knee proprioception was prospectively studied following ACL reconstruction in 40 patients (34 men and six women; mean age 31 years). The patients were allocated into two equal groups; group A underwent renonsruction using hamstrings autograft, and group B underwent reconstruction using bone-patellartendon-bone autograft. Proprioception was assessed in flexion and extension by the joint position sense(JPS) at 15°, 45° and 75°, and time threshold to detection of passive motion (TTDPM) at 15° and 45°, preoperatively and at 3, 6 and 12 months postoperatively. The contralateral healthy knee was used as internal control. No statistical difference was found between the ACL-operated and the contralateral knees in JPS 15°, 45° and 75° at 6 and 12 months, in both study groups. No statistical difference was found between the ACL-operated and the contralateral knees in TTDPM 15° at 6 and 12 months, nor regarding TTDPM 45° at 3, 6 and 12 months, in group A. No statistical difference was found in JPS and TTDPM between the two grafts, at any time period. Knee proprioception returned to normal with ACL reconstruction at 6 months postoperatively, without any statistically significant difference between the autografts used. The assessment of restoration of joint function following ligament reconstruction was also recorded using the aforementioned autografts, the use of the Lysholm scale, and was as well based on the single leg hop tests relating to distance (One-legged hop for distance) and with respect to time (One-legged timed hop). Following ligament reconstruction, good to perfect improvement in function was recorded 6-12 months following surgery. It is worth mentioning that there was no statistically significant difference between the two autografts. Still, regarding the One-legged hop for distance test, a greater value for improvement was observed following a four starnd hamstrings graft. No statistically significant correlation was observed between the variables of functionality and proprioception parameters; except for the hamstrings group and sparse values, through which no safe conclusions can be reached. Anterior-Posterior instability of the knee improved following arthroscopic ACL reconstruction. The bone-patellar tendon-bone graft presented with an obvious greater stability. The specific group that underwent surgery revealed reduction of anteroposterior stability values to an extent were no statistical significance with the normal values even after 3 months post-surgically was observed. Between grafts no statistically significant difference in patient satisfaction from the surgery and post-surgical rehabilitation was recorded, using a 0-100 scale. Both grafts appear to fufill patient expectations following ACL Patient satisfaction at 12 months after the group A ( four strand hamstrings graft group) was found to be linked with patient functional activities, as recorded on the Lyshlom scale, in terms of statistical significance.