title: Proprioception in the posterior cruciate ligament deficient knee.
abstract: This study was undertaken to evaluate knee proprioception in patients with isolated unilateral posterior cruciate ligament (PCL) injuries. Eighteen subjects with isolated PCL tears were studied 1-234 months after injury. The threshold to detect passive motion (TTDPM) was used to evaluate kinesthesia and the ability to passively reproduce passive positioning (RPP) to test joint position sense. Two starting positions were tested in all knees: 45 degrees (middle range) and 110 degrees (end range) to evaluate knee proprioception when the PCL is under different amounts of tension. TTDPM and RPP were tested as the knee moved into flexion and extension from both starting positions. A statistically significant reduction in TTDPM was identified in PCL-injured knees tested from the 45 degrees starting position, moving into flexion and extension. RPP was statistically better in the PCL-deficient knee as tested from 110 degrees moving into flexion and extension. No difference was identified in the TTDPM starting at 110 degrees or in RPP with the presented angle at 45 degrees moving into flexion or extension. These subtle but statistically significant findings suggest that proprioceptive mechanoreceptors may play a clinical role in PCL-intact and PCL-deficient patients. Further, it appears that kinesthesia and joint position sense may function through different mechanisms.
authors.affiliation: Department of Orthopaedic Surgery, University of California at Irvine, Kaiser Permanente, Orange County, 3010 West Orange Ave., Anaheim, CA 92804, USA. Marc.R.Safran@KP.org
authors.forename: M R
authors.initials: MR
authors.lastname: Safran
authors.forename: A A
authors.initials: AA
authors.lastname: Allen
authors.forename: S M
authors.initials: SM
authors.lastname: Lephart
authors.forename: P A
authors.initials: PA
authors.lastname: Borsa
authors.forename: F H
authors.initials: FH
authors.lastname: Fu
authors.forename: C D
authors.initials: CD
authors.lastname: Harner
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000209:etiology; D004056:Differential Threshold / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D007718:Knee Injuries / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008465:Mechanoreceptors / Q000503:physiopathology; D008875:Middle Aged; D009068:Movement; D009119:Muscle Contraction / Q000502:physiology; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000503:physiopathology; D011187:Posture; D011434:Proprioception / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012421:Rupture; D016037:Single-Blind Method; D016474:Weight-Bearing / Q000502:physiology