Abstract
ABSTRACTPurposeThe purpose of this study is to investigate the proprioceptive function of patients with isolated articular cartilage lesions of the knee as compared to normal controls.MethodsThe Cartilage group consisted of eight subjects with radiologically and arthroscopically confirmed, isolated, unilateral, articular cartilage lesions of the knee (Outerbridge grade III or IV). They were compared to 50 normal controls. Knee proprioception was assessed by dynamic postural stabilometry using the Biodex Balance SD System. Patient-reported outcome measures (PROMs) were used to evaluate all subjects.ResultsProprioception of the injured knee of the Cartilage group was significantly poorer compared to that of the control group (p < 0.001). A significant proprioceptive deficit also was observed when the uninjured knees of the Cartilage group were compared to those in the Control group (p = 0.003). There was no significant proprioceptive difference between the injured and the contra-lateral uninjured knee of the Cartilage group (p = 0.116). A significant correlation was found between the proprioception measurements of the injured and uninjured knee of the Cartilage group (r = 0.76, p = 0.030). A significant difference was observed in all PROMs (p < 0.001) between the Cartilage and Control groups.ConclusionsPatients with isolated articular cartilage lesions of the knee had a significant proprioceptive deficit as compared to normal controls. The deficiency was profound and even affected the proprioceptive function of the contra-lateral uninjured knee. This study has shown that articular cartilage lesions have a major influence on knee proprioception. However, it remains uncertain as to whether a proprioceptive deficit leads to osteoarthritis or is a consequence of it.
Highlights
Articular cartilage is generally considered an avascular, aneural and alymphatic structure
The results of this study found that a significant proprioceptive deficit exists as measured by dynamic, single-leg, Table 3 Comparison of patient-reported outcome measures of the Cartilage group (n = 8) and Control group (n = 50)
We found no significant difference in proprioception between the injured knee and the uninjured knee of the Cartilage group
Summary
Articular cartilage is generally considered an avascular, aneural and alymphatic structure. Little is known about the role that articular cartilage has in the proprioceptive feedback mechanism of the knee. The central nervous system receives a collective neural input from peripheral receptors (mechanoreceptors) found within joints, ligaments, tendons, muscles and skin [3, 5, 9, 10]. These include Pacinian corpuscles, Ruffini endings and Golgi tendon organs [5, 11, 12]. Mechanoreceptors are activated by mechanical deformations and send frequency-modulated
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