Effect of drains on dynamic proprioception after arthroscopically assisted anterior cruciate ligament reconstruction
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20164177Keywords:
Anterior cruciate ligament, Star excursion balance test, Proprioception, Drains, Hamstring graftAbstract
Background: Decrease in proprioception and kinesthesia occurs after ACL injury. Changes occurring within the joint following injury affect normal recruitment and firing patterns of the surrounding musculature. There are little data in the literature with reference to drain use after arthroscopic procedures on the knee or ACL reconstruction. The objective of the study was to determine the effect of postoperative drain use on proprioception after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction with quadrupled hamstring graft.
Methods: In this study, 54 arthroscopic ACL reconstruction patients were randomized for either intra-articular suction drain group or non-drain group. Outcome Assessment was done at 1 month, 3, 6 and 12 months after the surgery in which patients were assessed using Star excursion balance test by measuring excursion distances in each of the 8 directions.
Results: Excursion distances in eight directions showed more increment in drainage tube (DT) group compared to no DT group. However it was found to be statistically significant only for posteromedial (p =0.018) and medial directions (p <0.001).
Conclusions: Postoperative drain should be used after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction with quadrupled hamstring graft for improving the deficits in dynamic posture control.
References
Limbird TJ, Shiavi R, Frazer M, Borra. HEMG profiles of knee joint musculature during walking: changes induced by anterior cruciate ligament deficiency. J Orthop Res. 1988;6(5):630-8.
Shiavi R, Zhang LQ, Limbird T, Edmondstone MA. Pattern analysis of electromyographic linear envelopes exhibited by subjects with uninjured and injured knees during free and fast speed walking. J Orthop Res. 1992;10:226-36.
Lewek M, Rudolph K, Axe M, Snyder-Mackler L. The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech. 2002;17:56–63.
Shelburne K, Pandy M, Anderson F, Torry M. Pattern of anterior cruciate ligament force in normal walking. J Biomech. 2004;37:797–805.
Fridén T, Zätterström R, Lindstrand A, Moritz U. Anterior-cruciate-insufficient knees treated with physiotherapy. Clin Orthop Relat Res. 1991;263:190–9.
Lephart S, Fu F. The role of proprioception in the treatment of sports injuries. Sports Sci Inj. 1995;1:96–102.
Beer KJ, Lombardi AV, Mallory TH, Vaughn BK. The efficacy of suction drains after routine total joint arthroplasty. J Bone Joint Surg Am. 1991;73:584-6.
Ovadia D, Luger E, Bickels J, Menachem A, Dekel S. Efficacy of closed wound drainage after total joint arthroplasty. A prospective randomized study. J Arthroplasty. 1997;12:317-21.
Kim YH, Cho SH, Kim RS. Drainage versus non drainage in simultaneous bilateral total hip arthroplasties. J Arthroplasty. 1998;13:156-61.
Hadden WA, McFarlane AG. A comparative study of closed-wound suction drainage vs. no drainage in total hip arthroplasty. J Arthroplasty. 1990;5(l):21–4.
Winter DA, Patla AE, Frank JS. (1990). Assessment of balance control in humans. Med prog technol. 1990;16(1):31–51.
Freeman MAR, Dean MRE, Hanham IWF. The etiology and prevention of functional instability of the foot. J Bone Joint Surg. 1965;47:669–77.
Hertel J, Gay M, Denegar C. Differences in postural control during single leg stance among healthy individuals with different foot types. J Athl Train. 2002;37(2):129–32.
Hertel J, Miller S, Denegar C. Intra tester and inter tester reliability during the Star Excursion Balance Test. J Sport Rehabil. 2000;9(2):104–16.
Kinzey S, Armstrong C. The reliability of the Star-Excursion test in assessing dynamic balance. J Orthop Sports Phys Ther. 1998;27:356–60.
Gray G.W. Lower Extremity Functional Profile. Adrian, MI: Wynn Marketing Inc; p. 1995.
Barrack RL. Proprioception in the anterior cruciate deficient knee. Am J Sports Med. 1989;17(1):1-6.
Miller J. Biomechanical analysis of the anterior balance reach test. Unpublished doctoral dissertation, Pennsylvania State University, University Park. 2001
Hertel J, Miller S, Denegar C. Intratester and intertester reliability during the Star Excursion Balance Tests. J Sports Rehabil. 2000;9:104-16.
Goldie P, Bach T, Evans O. Force platform measures for evaluating postural control: reliability and validity. Arch Phys Med Rehabil. 1989;70:510–7.
Coupens SD, Yates CK. The effect of tourniquet use and hemovac drainage on postoperative hemarthrosis. Arthroscopy. 1991;7:278–82.
Browett JP, Gibbs AN, Copeland SA, Deliss LJ. The use of suction drainage in the operation of meniscectomy. J Bone Joint Surg. 1978;60:516–9.
Holt BT, Parks NL, Engh GA, Lawrence JM. Comparison of closed suction drainage and no drainage after primary total knee arthroplasty. Orthopedics. 1997;20:1121-4.
