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Joint Sense after Knee Replacement Surgery

Total knee replacement (TKR) has become a very successful surgery. Surgeons are still studying new techniques to make TKR even better. In this study, the authors looked at the way two different types of artificial knees affect joint sense.

Joint sense is also known as proprioception. It refers to the ability to sense position and movement. Good joint sense in the knee allows for good balance and strong, coordinated movement. Damage to the nerves and soft tissues of the knee can knock joint sense out of whack. So can TKR surgery.

The posterior cruciate ligament (PCL) in the knee is very important to the knee's joint sense. The PCL is saved in TKR surgery when certain types of artificial joints are used. For other types of artificial joints the PCL is removed. Some surgeons think that saving the PCL improves joint sense in the knee after surgery. These authors wanted to find out if that is true.

Both types of artificial joints were used in this study. The PCL was saved in the cruciate-retaining joint. It was not saved in the posterior stabilized joint. Both joints have good overall results. But which one of them showed better results for joint sense?

To find out, 20 TKR patients were tested before and at least six months after surgery. Researchers tested patients' balance. They also blindfolded the patients and made them recreate knee positions and sense movement. Joint sense improved for all patients after TKR surgery, no matter which type of artificial joint they had. In fact, the results were very similar for both groups.

The bottom line is that both types of artificial joints seemed to give equally good joint sense. The authors say that there may be reasons to choose cruciate-retaining artificial joints. However, better joint sense after TKR surgery isn't one of those reasons.

References: C. Buz Swanik, PhD, ATC, et al. Proprioception, Kinesthesia, and Balance after Total Knee Arthroplasty with Cruciate-Retaining and Posterior Stabilized Prostheses. In The Journal of Bone and Joint Surgery. February 2004. Vol. 86-A. No. 2. Pp. 328-334.

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