Proprioception in anterior cruciate ligament reconstruction. Endoscopic versus open two-tunnel technique. A prospective study.
ACL-reconstruction with patellar tendon autograft is a standard procedure which can be performed arthroscopically with a femoral half tunnel drilled from the joint or using the two-tunnel technique with medial miniarthrotomy and additional femoral approach. The arthroscopic procedure with single incision was hypothesized to improve proprioception and to provide earlier rehabilitation. Twenty-nine patients with chronic ACL-deficiency were included in the prospective study. Fifteen patients were operated endoscopically, 14 patients using the two-tunnel technique. Proprioception, Lysholm and Tegner scores as well as stability (KT-1000) were assessed preoperatively, 3 and 6 months postoperatively as well as after 3.9 +/- 0.4 years. A significant deficit of proprioception was assessed in both groups preoperatively. Six months postoperatively, both groups showed a restitution of proprioception near full extension and full flexion of the knee. In the mid-range position, the proprioception could not be restored. At the final examination after 3.9 years, the deficit documented in the mid-range position still persisted. There were no differences in proprioception, clinical results and stability between the arthroscopic and the open technique.
Trauma Department, Hannover Medical School, Germany. ReinhardFremerey@t-online.de
R
R
Fremerey
P
P
Lobenhoffer
M
M
Skutek
T
T
Gerich
U
U
Bosch
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability; D007718:Knee Injuries / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011434:Proprioception; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013709:Tendon Transfer; D013710:Tendons / Q000637:transplantation