R. Fremerey et al., Proprioception in anterior cruciate ligament reconstruction. Endoscopic versus two-tunnel technique, UNFALLCHIRU, 103(10), 2000, pp. 864-870
ACL reconstruction with patellar tendon autograft is a standard procedure w
hich can be performed arthroscopically with a femoral half tunnel drilled f
rom the joint or using the two-tunnel technique with medial miniarthrotomy
and additional femoral approach. The arthroscopic procedure with single inc
ision was supposed to increase stability and to improve proprioception by e
arlier rehabilitation. 29 patients with ACL deficiency were included in the
study. 15 patients were treated endoscopically, 14 patients by using the t
wo-tunnel technique. Proprioception, Lysholm and Tegner scores as well as s
tability (KT-1000) were assessed preoperatively, 3 and 6 months postoperati
vely.
A deficit of proprioception was assessed in either group preoperatively,whi
ch could be improved after 3 months only in the arthroscopic group. 6 month
s postoperatively, either group 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. There were no differences in stabili
ty and the Lysholm and Tegner scores between the groups after 6 months post
operatively.
The comparison between the patients with acute and chronic instability show
s a better proprioception in the acute group in the mid range position 6 mo
nths after the reconstruction.