Making Sense of Joint Sensation after Knee SurgeryInjury of the anterior cruciate ligament (ACL) in the knee is more than just a tear in the ligament. Sensation changes, too. The patient no longer has a normal sense of the joint's position. Signals that tell the joint and nearby tissues what position they're in is called proprioception.
The link between the ACL and proprioception is important. Normally, the signals tell the knee muscles to contract. This steadies the knee against outside forces. Without it, the knee has less protection.
Researchers at the University of Chicago are looking at proprioception in the knee with a torn ACL. Does it get better faster after surgery depending on the type of operation? Does proprioception come back slower if the meniscus or bone is damaged? How soon after surgery does this sense of position return?
Studies are being done to answer these and other questions. Special equipment is used to help with this. Physical therapists use a special device to measure two types of proprioception. In a recent study, 26 patients were measured after an ACL repair. No difference in proprioception was seen until six months after surgery.
The authors of this study aren't sure if this is the result of the operation or the rehab program after surgery. Proprioception improved in both the injured knee and the opposite knee six months after the surgery. Improvement is more likely to occur when surgery is done soon after the original injury.
There are still many questions about the knee after ACL repair. Are some patients more likely to recover faster because of their genetic makeup? Does a lack of training lead to slower return of proprioception? Is it the surgery or the rehab afterwards that makes a difference? More studies are needed before we'll have the answers to these questions.
Bruce Reider, MD, et al. Proprioception of the Knee Before and After Anterior Cruciate Ligament Reconstruction. In Arthroscopy. January 2003. Vol. 19. No. 1. Pp. 2-12.
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