Proprioception in Anterior Cruciate Ligament Reconstruction. Endoscopic versus Open Two-Tunnel Technique

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.

Key words:

ACL-deficiency, ACL-reconstruction, two-tunnel technique, proprioception, arthroscopy.

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