Mechanoreceptors of the Posterior Cruciate Ligament

Kwack

2013

Knee Surg Relat Res

PurposeTo evaluate the clinical and radiological results and proprioception following anterolateral single-bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation for PCL injury.Materials and MethodsTwenty patients with an isolated PCL injury (16 males and 4 females) were included in this study. The mean follow-up period was 61 months (≥24 months) and the mean age of the patients was 36 years. Knee joint instability was evaluated using posterior drawer stress radiography. Knee function, level of activities, and individual satisfaction were assessed using the Lysholm knee score, Tegner activity score, and 2000 International Knee Documentation Committee (IKDC) score. Knee proprioception was assessed using an isokinetic machine.ResultsThe mean ligament laxity assessed using the posterior drawer stress radiography was improved from 10.8-3.2 mm. The mean Lysholm knee score was improved from 70.0-88.9 points, and the mean Tegner activity score was improved from 2.7-6.2 points. Individual satisfaction assessed using the IKDC score was improved from 62.7-85.4 points (p<0.05). Knee proprioception was not significantly different between the treated and the uninjured knees.ConclusionsSingle-bundle PCL reconstruction with remnant preservation for PCL injury exhibited satisfactory outcomes regarding functional outcome, joint stability, and proprioception.

Section: Discussionmentioning

confidence: 99%

“…Thus, an injury to the PCL results in constant posterior instability of the knee, proprioception deficits due to the lack of information from mechanoreceptors, atrophy or muscle weakness, and knee joint degeneration2).…”

Section: Introductionmentioning

confidence: 99%

Proprioception and Clinical Results of Anterolateral Single-Bundle Posterior Cruciate Ligament Reconstruction with Remnant Preservation

Kwack

2013

Knee Surg Relat Res

“…40,41 Patients enjoy improved static stability when standing on both legs, thereby minimizing the risk of falls; and weight-bearing per se serves as a co-strengthening exercise and a form of proprioceptive training. [40][41][42] Brinkman et al 43 reported no difference in mean plate migration (as revealed by radiosterometric tests) between patients undergoing early and delayed weight-bearing. Another study by Hernigou et al (2015) 44 reported no group differences between the hip-knee-ankle angle, tibial slope, or the Caton index.…”

Section: Discussionmentioning

confidence: 99%

Distribution of the Force in the Knee Joint during Daily Activities after Open Wedge High Tibial Osteotomy: A Rationale for the Proper Postoperative Management

Seo

Lim

Jang³

et al. 2019

J Knee Surg

The present study was conducted to evaluate the force distribution in knee joint during daily activities after open-wedge high tibial osteotomy (OWHTO). A three-dimensional proximal tibial finite element model (FEM) was created using Mimics software to evaluate computed tomography (CT) scans of the tibia after OWHTO. The anterior and posterior gaps were 7.0 and 12.1 mm, respectively, and the target opening angle was 12 degrees. The loading ratio of the medial and lateral tibial plateaus was 6:4. To evaluate force distribution in the knee joint during activities of daily living (ADLs) after OWHTO, peak von Mises stresses (PVMSs) were analyzed at the plate and posterolateral edge region of osteotomized tibia. ADLs associated with greater knee flexion (sitting 90 degrees, standing 90 degrees, bending 90 degrees, stepping up stairs 60 degrees, and stepping downstairs 30 and 60 degrees) yielded PVMSs ranging from 195.2 to 221.5 MPa at the posterolateral edge region. In particular, stepping downstairs with knee flexion to 60 degrees produced the highest PVMS (221.5 MPa), greater than the yield strength (100–200 MPa). The highest plate PVMS was greater than 300 MPa during ADLs associated with flexion angles of approximately 90 degrees. However, these values did not exceed the yield stress (760.0 MPa). Conclusively, higher force was generated during higher flexion associated with weight-bearing and stepping downstairs produced a high force (even at lower flexion) on the posterolateral area of the tibial plateau. Therefore, a caution should be exercised when engaging in knee flexion of approximately 90 degrees and stepping downstairs in the early postoperative period when patients follow a weight-bearing rehabilitation protocol. However, this study is based on modeling; further translational studies are needed prior to clinical application.

Medicine &Amp; Science in Sports &Amp; Exercise

“…Pacinian corpuscles are low-threshold, quick adapting mechanoreceptors found in the extra-and intra-articular fat pad, medial meniscus, anterior and posterior cruciate ligaments (ACL and PCL), meniscofemoral, and collateral ligaments. They are stimulated by deformation of tissue due to quick changes in velocity and direction in the initial and end phases of a joints ROM and their role is to mediate the sensation of joint motion (Katonis et al, 2008;Voight et al, 1996). Ruffini endings are lowthreshold, slow adapting mechanoreceptors (i.e.…”

Section: Proprioceptionmentioning

confidence: 99%

Acute Effects of Two Hip Flexor Stretching Techniques on Knee Joint Position Sense and Balance

Aslan

Suprak

Buddhadev

et al. 2018

The purpose of this investigation was to examine the acute effects of two hip flexor stretching techniques on hip extension ROM, knee joint position sense (JPS) and dynamic balance performance (DB). Thirty-six healthy college age students (25 males, 11 females; mean=22.39 years) who exhibited hip flexor tightness participated in this study. Hip extension ROM, knee JPS and DB were tested pre-and post-stretching using digital inclinometer, iPod touch and the Y-balance kit, respectively. Subjects were randomly divided into dynamic (DS), and hold-relax proprioceptive neuromuscular facilitation (HR-PNF) groups. Three-way mixed analysis of variance (ANOVA) was utilized to explore if an interaction between the groups (DS vs. HR-PNF), time (pre-and post) and (side of hip, knee angle and direction or reach) existed over the experiment as specified by hip extension ROM, knee JPS and dynamic balance measurements, respectively. There was a significant effect of time on hip extension ROM in both stretching groups (p<0.001). Also, there was a significant effect of stretch type on hip extension ROM (p=0.004) favoring HR-PNF over DS. There was a non-significant effect of time on mean knee JPS replication error in both groups. In dynamic balance measurement, there was a significant main effect of time on the Y-balance test's mean distance (p<0.001). There was also a significant main effect of directions of reach on distances achieved (p<0.001) favoring reach distance to posterolateral direction over posteromedial, and the latter over anterior direction. The results of this study demonstrated that dynamic and HR-PNF stretching techniques resulted in a significant acute improvement in hip extension ROM, dynamic balance measures. However, knee JPS replication error results showed nonsignificant improvement over time in either stretching group. v