Intraoperative RHCL (Reflex Hamstring Contraction Latency) Bestimmung unter direkter mechanischer Reizung des vorderen Kreuzbandes
LicenseStandard (Fassung vom 03.05.2003)
A rupture of the anterior cruciate ligament (ACL) is a common injury observed in the clinic. After an injury to the ACL the patients may notice a subjective instability. This instability has two components: mechanical instability and functional instability. After good surgical stabilization of the ACL resulting in mechanical stability, patients frequently complain of functional knee instability. Many authors have described a reflex arc between the ACL and the hamstrings. It has also been shown, that compared with healthy subjects, those patients have a considerably increased latency period in their hamstring reflexes after anterior tibia translation. So far direct mechanical stimulation of the ACL was only described by animals. The aim of this study was to determine if there is a direct reflex response after an isolated intraoperative mechanical stimulation of the ACL in humans. A direct reflex response would be indicated by a correlation between the mechanical stimulation of the ACL and the mechanical stimulation of the ACL in reliance of the impact. In 10 patients who underwent regular arthroscopy, hamstring electromyographic (EMG) responses were assessed intraoperatively after applying an isolated impact to the ACL. In all subjects, a short latency response (SLR) of 24, 6 ± 2, 6 ms and a medium latency response (MLR) 41, 3 ± 3, 2 ms were measured. In relation to the impact groups, there was no significant difference. After direct mechanical stimulation of the ACL, we demonstrated a SLR and MLR reflex answer. There was no significant difference between the mean latencies and the mean impact groups latencies. As expected, the dimension of the reflex answer in relation to the maximum amplitude and the integral increased.
Subject HeadingsKreuzbandriss [GND]
Ligamentum cruciatum anterius [GND]
Anterior cruciate ligament [MeSH]