Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 15, Issue 12, pp 1432–1437 | Cite as

Proprioceptive comparison of allograft and autograft anterior cruciate ligament reconstructions

  • A. Merter OzenciEmail author
  • Erkan Inanmaz
  • Haluk Ozcanli
  • Yetkin Soyuncu
  • Nehir Samanci
  • Tufan Dagseven
  • Nilüfer Balci
  • Semih Gur


The aim of this study is to search if there is any proprioceptive difference between auto and allograft anterior cruciate ligament (ACL) reconstructions, and also to determine if there is any relationship between instrumented anterior knee laxity and proprioception after an ACL reconstruction. The following four groups were constituted for this purpose: group I, control group; group II, autograft reconstructions; group III, allograft reconstructions and group IV, people with injured ACLs. Each group consisted of 20 patients/volunteers. Two subgroups were constituted according to the findings of KT-1000 laxity testing in group II and III; patients/volunteers found to have a laxity of 3 mm or less were enroled in the normal subgroup and those with a laxity of more than 3 mm were enroled in the lax subgroup. Two proprioceptive tests were used: threshold to detect passive motion (TDPM) and joint position sense (JPS) by using Cybex Norm dynamometer. Patients underwent ten tests and the discrepancy in degrees was averaged for ten trials. Comparisons were made to evaluate the proprioceptive differences between groups/subgroups; ANOVA and t test was used for comparisons where appropriate, and the significance was set at P < 0.05. There was a significant difference in degrees between patients with injured ACLs and the other three groups in TDPM evaluations (injured: 1.93° vs. control: 1.03°, autograft: 1.01°, allograft: 0.96°; P < 0.001). Auto and allograft reconstructions were not different from each other and controls. Allo and autograft ACL reconstructions are not different from each other according to proprioceptive measurements. Also, proprioception is not correlated to postoperative anterior knee laxity; many variables involve joint proprioception and mostly the anterior knee laxity may not be the sole determining element, and a lax ACL still may fulfill some of its afferent arc functions as long as it bridges the femur and tibia.


Allograft Proprioception Anterior cruciate ligament (ACL) Knee Reconstruction 



This study was supported by the Akdeniz University Research Foundation, Antalya, Turkey.


  1. 1.
    Barrack RL, Skinner HB, Buckley SL (1989) Proprioception in the anterior cruciate deficient knee. Am J Sports Med 17:1–6PubMedCrossRefGoogle Scholar
  2. 2.
    Barrett DS (1991) Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg (Br) 73:833–837Google Scholar
  3. 3.
    Borsa PA, Lephart SM, Irrgang JJ (1998) Comparison of performance-based and patient-reported measures of function in anterior-cruciate-ligament-deficient individuals. J Orthop Sports Phys Ther 28:392–399PubMedGoogle Scholar
  4. 4.
    Carter ND, Jenkinson TR, Wilson D, Jones DW, Torode AS (1997) Joint position sense and rehabilitation in the anterior cruciate ligament deficient knee. Br J Sports Med 31:209–212PubMedCrossRefGoogle Scholar
  5. 5.
    Chang SK, Egami DK, Shaieb MD, Kan DM, Richardson AB (2003) Anterior cruciate ligament reconstruction: allograft versus autograft. Arthroscopy 19:453–462PubMedCrossRefGoogle Scholar
  6. 6.
    Corrigan JP, Cashman WF, Brady MP (1992) Proprioception in the cruciate deficient knee. J Bone Joint Surg (Br) 74:247–250Google Scholar
  7. 7.
    Duthon VB, Barea C, Abrassart S, Fasel JH, Fritschy D, Menetrey J (2006) Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 14:204–213PubMedCrossRefGoogle Scholar
  8. 8.
    Dyhre-Poulsen P, Krogsgaard MR (2000) Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans. J Appl Physiol 89:2191–2195PubMedGoogle Scholar
  9. 9.
    Fremerey RW, Lobenhoffer P, Zeichen J, Skutek M, Bosch U, Tscherne H (2000) Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament: a prospective, longitudinal study. J Bone Joint Surg (Br) 82:801–806CrossRefGoogle Scholar
  10. 10.
    Friden T, Roberts D, Ageberg E, Walden M, Zatterström R (2001) Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture. J Orthop Sports Phys Ther 31:567–576PubMedGoogle Scholar
  11. 11.
    Friden T, Roberts D, Zatterström R, Lindstrand A, Moritz U (1996) Proprioception in the nearly extended knee. Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients. Knee Surg Sports Traumatol Arthrosc 4:217–224PubMedCrossRefGoogle Scholar
  12. 12.
    Friden T, Roberts D, Zatterström R, Lindstrand A, Moritz U (1997) Proprioception after an acute knee ligament injury: A longitudinal study on 16 consecutive patients. J Orthop Res 15:637–644PubMedCrossRefGoogle Scholar
  13. 13.
    Fromm B, Kummer W (1994) Nerve supply of anterior cruciate ligaments and of cryopreserved anterior cruciate ligament allografts: a new method for the differentiation of the nervous tissues. Knee Surg Sports Traumatol Arthrosc 2:118–122PubMedCrossRefGoogle Scholar
  14. 14.
    Goertzen M,Gruber J, Dellman A, Clahsen H, Schulitz KP (1993) Neurohistological studies in allogeneic cruciate ligament transplants as intra-articular ligament replacement. Z Orthop Ihre Grenzgeb 131:420–424PubMedGoogle Scholar
  15. 15.
    Good L, Roos H, Gottlieb DJ, Renstrom PA, Beynnon BD (1999) Joint position sense is not changed after acute disruption of the anterior cruciate ligament. Acta Orthop Scand 70:194–198PubMedCrossRefGoogle Scholar
  16. 16.
    Grob KR, Kuster MS, Higgins SA, Lloyd DG, Yata H (2002) Lack of correlation between different measurements of proprioception in the knee. J Bone Joint Surg (Br) 84:614–618CrossRefGoogle Scholar
  17. 17.
    Harner CD, Olson E, Irrgang JJ, Silverstein S, Fu FH, Silbey M (1996) Allograft versus autograft anterior cruciate ligament reconstruction: 3- to 5-year outcome. Clin Orthop Relat Res 324:134–144PubMedCrossRefGoogle Scholar
  18. 18.
    Haus J, Halata Z (1990) Innervation of the anterior cruciate ligament. Int Orthop 14:293–296PubMedCrossRefGoogle Scholar
  19. 19.
    Hogervorst T, Brand RA (1998) Mechanoreceptors in joint function. J Bone Joint Surg 80(A):1365–1378PubMedGoogle Scholar
  20. 20.
    Iwasa J, Ochi M, Adachi N, Tobita M, Katsube K, Uchio Y (2000) Proprioceptive improvement in knees with anterior cruciate ligament reconstruction. Clin Orthop Relat Res 381:168–176PubMedCrossRefGoogle Scholar
  21. 21.
    Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the human knee and its functional importance. Am J Sports Med 10:329–335PubMedCrossRefGoogle Scholar
  22. 22.
    Kleipool AE, Zijl JA, Willems WJ (1998) Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft or autograft. A prospective study with an average follow up of 4 years. Knee Surg Sports Traumatol Arthrosc 6:224–230PubMedCrossRefGoogle Scholar
  23. 23.
    Lephart SM, Fu FH (1995) The role of proprioception in the treatment of sports injuries. Sports Exerc Injury 1:96–102Google Scholar
  24. 24.
    Lephart SM, Kocher MS, Fu FH, Borsa PA, Harner CD (1992) Proprioception following anterior cruciate ligament reconstruction. J Sports Rehab 1:188–196Google Scholar
  25. 25.
    Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y (1999) The regeneration of sensory neurones in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg (Br) 81:902–906CrossRefGoogle Scholar
  26. 26.
    Pap G, Machner A, Nebelung W, Awiszus F (1999) Detailed analysis of proprioception in normal and ACL-deficient knees. J Bone Joint Surg (Br) 81:764–768CrossRefGoogle Scholar
  27. 27.
    Peterson RK, Shelton WR, Bomboy AL (2001) Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: a 5-year follow-up. Arthroscopy 17:9–13PubMedCrossRefGoogle Scholar
  28. 28.
    Reider B, Arcand MA, Diehl LH, Mroczek K, Abulencia A, Stround CC, Palm M, Gilbertson J, Staszak P (2003) Proprioception of the knee before and after anterior cruciate ligament reconstruction. Arthroscopy 19:2–12PubMedCrossRefGoogle Scholar
  29. 29.
    Roberts D, Ageberg E, Andersson G, Friden T (2007) Clinical measurements of proprioception, muscle strength and laxity in relation to function in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc 15:9–16PubMedCrossRefGoogle Scholar
  30. 30.
    Roberts D, Friden T, Stomberg A, Lindstrand A, Moritz U (2000) Bilateral proprioceptive defects in patients with a unilateral anterior cruciate ligament reconstruction: a comparison between patients and healthy individuals. J Orthop Res 18:565–571PubMedCrossRefGoogle Scholar
  31. 31.
    Schultz RA, Miller DC, Kerr CS, Micheli L (1984) Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg 66(A):1072–1076PubMedGoogle Scholar
  32. 32.
    Tsuda E, Okamura Y, Otsuka H, Komatsu T, Tokuya S (2001) Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans. Am J Sports Med 29:83–87PubMedGoogle Scholar
  33. 33.
    Zimny ML, Schutte M, Dabezies E (1986) Mechanoreceptors in the human anterior cruciate ligament. Anat Rec 214:204–209PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • A. Merter Ozenci
    • 1
    Email author
  • Erkan Inanmaz
    • 1
  • Haluk Ozcanli
    • 1
  • Yetkin Soyuncu
    • 1
  • Nehir Samanci
    • 2
  • Tufan Dagseven
    • 2
  • Nilüfer Balci
    • 2
  • Semih Gur
    • 1
  1. 1.Department of Orthopaedics and TraumatologyAkdeniz University School of MedicineAntalyaTurkey
  2. 2.Department of Physical Therapy and RehabilitationAkdeniz University School of MedicineAntalyaTurkey

Personalised recommendations