后交叉韌帶保留與否對膝關節本體感覺的影響_《中國修復重建外科雜志》

作者：

吳彥生 ¹ , 李永勝 ¹ , 陳百成 ²

1故城縣醫院骨科（河北故城，253800）;;
2河北醫科大學第三醫院關節一科;

關鍵詞：

人工全膝關節置換術后交叉韌帶本體感覺骨性關節炎

DOI：

10.7507/1002-1892.20130186

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目的比較人工全膝關節置換術（total knee arthroplasty，TKA）保留或不保留后交叉韌帶（posterior cruciate ligament，PCL）對術后膝關節本體感覺的影響。方法將2009年6月－2010年6月收治且符合選擇標準的38例骨性關節炎患者，按隨機數字表法分為PCL保留組（A組）和PCL替代組（B組），各19例。兩組患者性別、年齡、病程及膝關節活動度等一般資料比較，差異均無統計學意義（P gt; 0.05），具有可比性。術前及術后12個月采用美國西部Ontario與McMaster大學骨關節炎指數評分（WOMAC）評價臨床療效，采用膝關節被動角度再生試驗進行30、60、90° 3個不同角度的本體感覺評定。結果術后切口均Ⅰ期愈合，無感染、骨折、下肢深靜脈血栓形成等并發癥發生。患者均獲隨訪，隨訪時間12～17個月，平均14.1個月。兩組患者膝關節功能均較術前顯著改善，術后12個月WOMAC評分及膝關節被動角度再生試驗結果與術前比較，差異均有統計學意義（P lt; 0.05）；兩組間比較，差異均無統計學意義（P gt; 0.05）。結論TKA術中無論PCL保留與否，患者術后膝關節本體感覺均較術前提高，保留或不保留PCL膝關節本體感覺無明顯差異。

引用本文： 吳彥生,李永勝,陳百成. 后交叉韌帶保留與否對膝關節本體感覺的影響. 中國修復重建外科雜志, 2013, 27(7): 851-854. doi: 10.7507/1002-1892.20130186 復制

1.	Yoon HS, Han CD, Yang IH. Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty, 2010, 25(2): 179-185.
2.	Pap G, Meyer M, Weiler HT, et al. Proprioception after total knee arthroplasty: a comparison with clinical outcome. Acta Orthop Scand, 2000, 71(2): 153-159.
3.	Swanik CB, Lephart SM, Rubash HE. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg (Am), 2004, 86-A(2): 328-334.
4.	Lattanzio PJ, Chess DG, MacDermid JC. Effect of the posterior cruciate ligament in knee-joint proprioception in total knee arthroplasty. J Arthroplasty, 1998, 13(5): 580-585.
5.	Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg (Br), 1991, 73(1): 53-56.
6.	Simmons S, Lephart S, Rubash H, et al. Proprioception following total knee arthroplasty with and without the posterior cruciate ligament. J Arthroplasty, 1996, 11(7): 763-768.
7.	Cash RM, Gonzalez MH, Garst J, et al. Proprioception after athroplasty: role of the posterior curciate ligament. Clin Orthop Relat Res, 1996, (331): 172-178.
8.	Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol, 1988, 15(12): 1833-1840.
9.	謝磊, 陳百成, 王曉峰, 等. 自體及同種異體肌腱重建前交叉韌帶術后本體感覺恢復的比較研究. 中國修復重建外科雜志, 2011, 25(8): 907-911.
10.	Maffiuletti NA, Bizzini M, Desbrosses K, et al. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer. Clin Physiol Funct Imaging, 2007, 27(6): 346-353.
11.	Duthon VB, Barea C, Abrassart S, et al. Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc, 2006, 14(3): 204-213.
12.	Reider B, Arcand MA, Diehl LH, et al. Proprioception of the knee before and after anterior cruciate ligament reconstruction. Arthroscopy, 2003, 19(1): 2-12.
13.	Schultz RA, Miller DC, Kerr CS, et al. Mechanoreceptors in human cruciate ligaments. J Bone Joint Surg (Am), 1984, 66(7): 1072-1076.
14.	Johansson H, Sjölander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop Relat Res, 1991, (268): 161-178.
15.	Kleinbart FA, Bryk E, Evangelista J, et al. Histological comparison of posterior cruciate ligaments from arthritic and age-matched knee specimens. J Arthroplasty, 1996, 11(6): 726-731.
16.	Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis, 2001, 60(6): 612-618.
17.	Skinner HB, Wyatt MP, Hodgdon JA, et al. Effect of fatigue on joint position sense of the knee. J Orthop Res, 1986, 4(1): 112-118.
18.	Beard DJ, Dodd CA, Trundle HR, et al. Proprioceotion enhancement for anterior cruciate ligament deficiency. A prospective randomized trial of two physiotherapy regimes. J Bone Joint Surg (Br), 1994, 76(4): 654-659.
19.	李建華, 壽依群, 陳文君. 膝關節本體感覺重建訓練對膝骨關節病患者位置覺改變的影響. 中國運動醫學雜志, 2003, 22(2): 191-192.
20.	Bastin J, Calvin S, Montagne G. Muscular proprioception contributes to the control of interceptive actions. J Exp Psychol Hum Percept Perform, 2006, 32(4): 964-972.
21.	Hurkmans EJ, van der Esch M, Ostelo RW, et al. Reproducibility of the measurement of knee joint proprioception in patients with osteoarthritis of the knee. Arthritis Rheum, 2007, 57(8): 1398-1403.
22.	Moezy A, Olyaei G, Hadian M, et al. A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. Br J Sports Med, 2008, 42(5): 373-378.
23.	Thijs Y, Witvrouw E, Evens B, et al. A prospective study on knee proprioception after meniscal allograft transplantation. Scand J Med Sci Sports, 2007, 17(3): 223-229.

1. Yoon HS, Han CD, Yang IH. Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty, 2010, 25(2): 179-185.
2. Pap G, Meyer M, Weiler HT, et al. Proprioception after total knee arthroplasty: a comparison with clinical outcome. Acta Orthop Scand, 2000, 71(2): 153-159.
3. Swanik CB, Lephart SM, Rubash HE. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg (Am), 2004, 86-A(2): 328-334.
4. Lattanzio PJ, Chess DG, MacDermid JC. Effect of the posterior cruciate ligament in knee-joint proprioception in total knee arthroplasty. J Arthroplasty, 1998, 13(5): 580-585.
5. Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg (Br), 1991, 73(1): 53-56.
6. Simmons S, Lephart S, Rubash H, et al. Proprioception following total knee arthroplasty with and without the posterior cruciate ligament. J Arthroplasty, 1996, 11(7): 763-768.
7. Cash RM, Gonzalez MH, Garst J, et al. Proprioception after athroplasty: role of the posterior curciate ligament. Clin Orthop Relat Res, 1996, (331): 172-178.
8. Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol, 1988, 15(12): 1833-1840.
9. 謝磊, 陳百成, 王曉峰, 等. 自體及同種異體肌腱重建前交叉韌帶術后本體感覺恢復的比較研究. 中國修復重建外科雜志, 2011, 25(8): 907-911.
10. Maffiuletti NA, Bizzini M, Desbrosses K, et al. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer. Clin Physiol Funct Imaging, 2007, 27(6): 346-353.
11. Duthon VB, Barea C, Abrassart S, et al. Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc, 2006, 14(3): 204-213.
12. Reider B, Arcand MA, Diehl LH, et al. Proprioception of the knee before and after anterior cruciate ligament reconstruction. Arthroscopy, 2003, 19(1): 2-12.
13. Schultz RA, Miller DC, Kerr CS, et al. Mechanoreceptors in human cruciate ligaments. J Bone Joint Surg (Am), 1984, 66(7): 1072-1076.
14. Johansson H, Sjölander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop Relat Res, 1991, (268): 161-178.
15. Kleinbart FA, Bryk E, Evangelista J, et al. Histological comparison of posterior cruciate ligaments from arthritic and age-matched knee specimens. J Arthroplasty, 1996, 11(6): 726-731.
16. Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis, 2001, 60(6): 612-618.
17. Skinner HB, Wyatt MP, Hodgdon JA, et al. Effect of fatigue on joint position sense of the knee. J Orthop Res, 1986, 4(1): 112-118.
18. Beard DJ, Dodd CA, Trundle HR, et al. Proprioceotion enhancement for anterior cruciate ligament deficiency. A prospective randomized trial of two physiotherapy regimes. J Bone Joint Surg (Br), 1994, 76(4): 654-659.
19. 李建華, 壽依群, 陳文君. 膝關節本體感覺重建訓練對膝骨關節病患者位置覺改變的影響. 中國運動醫學雜志, 2003, 22(2): 191-192.
20. Bastin J, Calvin S, Montagne G. Muscular proprioception contributes to the control of interceptive actions. J Exp Psychol Hum Percept Perform, 2006, 32(4): 964-972.
21. Hurkmans EJ, van der Esch M, Ostelo RW, et al. Reproducibility of the measurement of knee joint proprioception in patients with osteoarthritis of the knee. Arthritis Rheum, 2007, 57(8): 1398-1403.
22. Moezy A, Olyaei G, Hadian M, et al. A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. Br J Sports Med, 2008, 42(5): 373-378.
23. Thijs Y, Witvrouw E, Evens B, et al. A prospective study on knee proprioception after meniscal allograft transplantation. Scand J Med Sci Sports, 2007, 17(3): 223-229.

《中國修復重建外科雜志》

后交叉韌帶保留與否對膝關節本體感覺的影響

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《中國修復重建外科雜志》

后交叉韌帶保留與否對膝關節本體感覺的影響

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