Proprioception in the Posterior Cruciate Lig

7/28/2019 Proprioception in the Posterior Cruciate Lig

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Hftrobucthof

Rng trgmtjgft oe hsoamtgb postgrhor cruchmtg ahimjgft.TCA( hfkurhgs hs coftrovgrshma& Rnhs hs pmrtay `gcmusg tng

fmturma nhstory oe tng hsoamtgb TCA hfkurgb lfgg hs ufcagmr&Ht nms ggf fotgb tnmt jmfy pmthgfts eufcthof wgaa! gvgf hfnhin agvga sports! whtn m torf TCA& Rnhs hs hf bhrgct cof*trmbhsthfcthof whtn tng MCA hfkurgb lfgg& Rng rgmsof eortnhs bheegrgfcg hs fot cagmr! ms tng TCA hs amrigr mfbstrofigr tnmf tng MCA&

Eor ygmrs lfgg surigofs nmvg postuamtgb tnmt tng sgf*sory aoss mssochmtgb whtn MCA hfkury jmy meegct tng rg*suats oe MCA rgpmhr mfb rgcofstructhof \3! 9! 2=Z& BuRoht\=8Z! Hfsmaa gt ma& \32Z! mfb otngrs \20! 29! 73Z nmvg maa mb*

vocmtgb cgrtmhf rgcofstructhvg tgcnfhqugs bug hf pmrt tohfcrgmsgb meegrgft prgsgrvmthof& M proprhocgpthvg bgehchtnms `ggf bgjofstrmtgb eoaaowhfi MCA bhsrupthof \3! 2! 9!=3Z< nowgvgr! fo ahtgrmturg gxhsts rgporthfi proprhocgpthofhf tng TCA bgehchgft lfgg&

Wfahlg coj`hfgb ahimjgft hfkurhgs hfvoavhfi tng TCA!tngrg hs jucn jorg bg`mtg mòut tng fmturma nhstory mfbtrgmtjgft oe tng hsoamtgb TCA*bgehchgft lfgg \8! =7! =5!=>! 00! 38! 7=! 53Z& Ht hs wgaa lfowf tnmt hf tng mftgrhorcruchmtg ahimjgft .MCA( bgehchgft lfgg hfstm`hahty mfbrghfkury cmf agmb to mrtnrhths ovgr thjg \>! 03! 3=! 25! 2>!72! 79! 5=Z& Eurtngr! mutnors suiigst tnmt eufcthof hf tngMCA*bgehchgft mfb MCA*rgcofstructgb lfgg hs jorg rgah*mày prgbhctgb `y proprhocgpthvg m`hahty tnmf pnyshcma gx*mjhfmthof or lfgg tgst scorgs \2! 9! =3! 33Z& Sgvgrma stub*

M`strmct Rnhs stuby wms ufbgr*tmlgf to gvmaumtg lfgg proprhocgp*thof hf pmthgfts whtn hsoamtgb ufhamt*

grma postgrhor cruchmtg ahimjgft.TCA( hfkurhgs& Ghintggf su`kgctswhtn hsoamtgb TCA tgmrs wgrg stubhgb=032 joftns metgr hfkury& Rngtnrgsnoab to bgtgct pmsshvg jothof.RRBTJ( wms usgb to gvmaumtglhfgstngshm mfb tng m`hahty to pms*shvgay rgprobucg pmsshvg poshthofhfi.PTT( to tgst kohft poshthof sgfsg&Rwo stmrthfi poshthofs wgrg tgstgb hfmaa lfggs; 27 .jhbbag rmfig( mfb==4 .gfb rmfig( to gvmaumtg lfggproprhocgpthof wngf tng TCA hs uf*

bgr bheegrgft mjoufts oe tgfshof&RRBTJ mfb PTT wgrg tgstgb ms tnglfgg jovgb hfto eagxhof mfb gxtgf*shof eroj òtn stmrthfi poshthofs& Mstmthsthcmaay shifhehcmft rgbucthof hfRRBTJ wms hbgfthehgb hf TCA*hf*

kurgb lfggs tgstgb eroj tng 27 stmrt*hfi poshthof! jovhfi hfto eagxhof mfbgxtgfshof& PTT wms stmthsthcmaay `gt*

tgr hf tng TCA*bgehchgft lfgg mstgstgb eroj ==4 jovhfi hfto eagxhofmfb gxtgfshof& Fo bheegrgfcg wmshbgfthehgb hf tng RRBTJ stmrthfi mt==4 or hf PTT whtn tng prgsgftgbmfiag mt 27 jovhfi hfto eagxhof orgxtgfshof& Rngsg su`tag ùt stmthsth*cmaay shifhehcmft ehfbhfis suiigst tnmtproprhocgpthvg jgcnmforgcgptorsjmy pamy m cahfhcma roag hf TCA*hf*tmct mfb TCA*bgehchgft pmthgfts& Eur*tngr! ht mppgmrs tnmt lhfgstngshm mfbkohft poshthof sgfsg jmy eufcthof

tnrouin bheegrgft jgcnmfhsjs&

Lgy worbs Tostgrhor cruchmtgahimjgft Troprhocgpthof Ahimjgft Lfgg

LFGGLfgg Suri! Sports Rrmujmtoa! Mrtnrosc.=888( 9 ; 3=43=9

Sprhfigr*Ugrami =888

J& P& SmermfM& M& MaagfS& J& AgpnmrtT& M& @orsm

E& N& EuC& B& Nmrfgr

Troprhocgpthof hf tng postgrhor cruchmtg

ahimjgft bgehchgft lfgg

Pgcghvgb; 7 Sgptgj`gr =88>Mccgptgb; 07 Jmy =888

J& P& Smermf .(Bgpmrtjgft oe Ortnopmgbhc Surigry!Wfhvgrshty oe Cmaheorfhm mt Hrvhfg!Lmhsgr Tgrjmfgftg!Ormfig Coufty!34=4 Ygst Ormfig Mvg&!Mfmnghj! CM 80>42! WSMg*jmha; Jmrc&P&SmermfDLT&oriRga&; ,=*9=2*0350>7=Emx; ,=*9=2*0350>>5

M& M& MaagfNosphtma eor Spgchma Surigry!Fgw Xorl! Fgw Xorl! WSM

S& J& Agpnmrt E& N& Eu C& B& Nmrfgr

Fgurojuscuamr Pgsgmrcn Amòrmtory!Wfhvgrshty oe Thttsùrin! =24 Rrggs Nmaa!Thttsùrin! TM =705=! WSM

T& M& @orsmOrgiof Stmtg Wfhvgrshty!Corvmaahs! Orgiof! WSM


2/8

hgs nmvg snowf tnmt proprhocgpthvg bgehchts tnmt gxhst hfMCA*bgehchgft lfggs cmf `g pmrthmaay rgstorgb `y surihcmargcofstructhof \3! 2! =0Z& Pgbucgb proprhocgpthof nms `ggfhjpahcmtgb hf tng bgvgaopjgft oe lfgg mrtnrhths \7! 78Z&

Jmfy mutnors fotg tnmt pmthgfts whtn hsoamtgb TCAbgehchgfcy hfhthmaay eufcthof wgaa wnhag proirgsshof to bg*igfgrmthvg mrtnrhths ovgr thjg hs agss wgaa bgehfgb \8! =>!

7=Z& Ro bmtg fo stubhgs nmvg `ggf pgreorjgb to bgtgrjhfgtng potgfthma proprhocgpthvg bgehchts hf tng TCA bgehchgftlfgg& Yhtn tnhs hfeorjmthof hf jhfb! ht wms tng purposg oetnhs stuby to cnmrmctgrhzg tng proprhocgpthvg cnmfigs hftng hsoamtgb TCA*bgehchgft lfgg&

Jmtgrhmas mfb jgtnobs

Ghintggf su`kgcts jgt tng crhtgrhm eor hfcaushof; hsoamtgb TCA hf*kury whtnout coftrmamtgrma lfgg hfkury! surigry or otngr cofcojh*tmft lfgg hfkury& Rng =3 jgf mfb 7 wojgf mvgrmigb 30 ygmrs oemig .rmfig =87=(& Rngsg pmthgfts mvgrmigb 08 joftns eroj thjgoe hfkury to proprhocgpthof tgsthfi .rmfig =032(& Rngrg wgrg =4rhint lfggs hfkurgb mfb > aget lfggs& Rng jgcnmfhsj oe hfkury wms

nypgrgxtgfshof hf 9! eagxhof/nypgreagxhof hf >! mfb uflfowf hf3& Jmfy oe tng pmthgfts prgsgftgb to Ortnopmgbhc Sports JgbhchfgSgrvhcg metgr hfhthma hfkury mfb eoaaowgb whtn cofsgrvmthvg jmf*migjgft& Jost oe tngsg pmthgfts wgrg mslgb to rgturf eor eoaaow*upmfb tgsthfi gvgf tnouin tngy rgjmhfgb msyjptojmthc mt amtgst gvma*umthof& Maa su`kgcts ufbgrwgft m cojpagtg nhstory mfb tnorouinlfgg gxmjhfmthof `y ofg oe tng mutnors! mf ortnopgbhc surigofspgchmahzhfi hf sports hfkurhgs& Rng `hamtgrma lfgg gxmjhfmthof hf*caubgb mssgssjgft oe lfgg rmfig oe jothof! aowgr gxtrgjhty mahif*jgft! prgsgfcg oe geeushof! pmtgaamr hrrhtm`hahty! pmtgaamr jothof! mf*tgropostgrhor mfb vmrus*vmaius stm`hahty! mfb jgfhscma shifs& Maaùt tnrgg hfbhvhbumas .hfcaubhfi tng ofg wno ufbgrwgft TCA rg*cofstructhof = joftn metgr tng hfkury( ufbgrwgft pnyshcma tngrmpystrgsshfi qumbrhcgps rgnm`hahtmthof&

Hf tng forjma lfgg tng jgbhma th`hma pamtgmu forjmaay hs =4 jjmftgrhor to tng jgbhma egjorma cofbyag whtn tng lfgg hf 84 eagx*

hof& Tostgrhor brmwgr tgsthfi eor TCA hfsueehchgfcy hs tngf irmbgbms eoaaows; hf irmbg H hfkury tngrg hs msyjjgtry shbg to shbg! ùt tngjgbhma th`hma pamtgmu rgjmhfs mftgrhor to tng jgbhma egjormacofbyag< hf irmbg HH hfkury tng postgrhor brmwgr mt 84 pusngs tngth`hma pamtgmu to tng agvga oe tng jgbhma egjorma cofbyag< hf irmbgHHH hfkury tng jgbhma th`hma pamtgmu cmf `g pusngb postgrhor to tngjgbhma egjorma cofbyag& Rng postgrhor smi hs irmbgb shjhamray; hfirmbg H tng jgbhma th`hma pamtgmu shts eurtngr postgrhoray tnmf tngforjma coftrmamtgrma lfgg ùt sthaa mftgrhor to tng jgbhma egjormacofbyag whtn tng lfgg eagxgb mpproxhjmtgay 84< hf irmbg HH tngth`hma pamtgmu hs mt tng agvga oe tng jgbhma egjorma cofbyag< hf irmbgHHH tng jgbhma th`hma pamtgmu rgsts postgrhor to tng jgbhma egjormacofbyag& @y bgehfhthof mf hsoamtgb TCA tgmr prgcaubgs hfcaushof oepmthgfts whtn hfkury to tng mftgrhor cruchmtg or coaamtgrma ahimjgft hftnhs stuby& Eurtngrjorg! postgrhor amtgrma rotmtory hfstm`hahty! bhmatgst! mt 34 just `g syjjgtrhc& Ht hs hjportmft to fotg eor tnhs

stuby tnmt wg tgstgb pmthgfts whtn truay hsoamtgb TCA tgmrs& Hf tngpmst jmfy so*cmaagb hsoamtgb irmbg HHH TCA hfkurhgs nmvg `ggf hf*caubgb hf stubhgs ms hsoamtgb hfkurhgs! matnouin cofcojhtmft cmpsu*amr mfb postgroamtgrma corfgr hfvoavgjgft ahlgay gxhstgb& Hf tnhsstuby tngsg pmthgfts wgrg gxcaubgb&

M stmfbmrb rmbhoirmpnhc lfgg sgrhgs! hfcaubhfi eagxhof wghint*`gmrhfi postgromftgrhor vhgw! amtgrma mfb sufrhsg vhgws! mfb mjmifgthc rgsofmfcg hjmihfi scmf wgrg o`tmhfgb of maa su`kgcts&LR*=444 hfstrujgftgb lfgg tgsthfi wms maso pgreorjgb to mssgsstng bgirgg oe amxhty oe òtn lfggs eor cojpmrhsof&

M proprhocgpthvg tgsthfi bgvhcg .TRB( wms usgb to jgmsurglhfgstngshm ms tng tnrgsnoab to bgtgcthof oe pmsshvg jovgjgft

.RRBTJ( mfb kohft poshthof sgfsg `y tng m`hahty to pmsshvgay rg*probucg kohft poshthofhfi .PTT< Ehi&=(& Rnhs bgvhcg nms `ggf usgbprgvhousay to mssgss proprhocgpthvg mwmrgfgss mfb hs pmhfagss totng su`kgcts \22Z& Rng TRB rotmtgs tng lfgg hfto eagxhof mfb gxtgf*shof tnrouin tng mxhs oe tng kohft& M rotmthofma trmfsbucgr hftgr*emcgb whtn m bhihtma jhcroprocgssor couftgr provhbgb tng mfiuamrbhspamcgjgft vmaugs bhrgctay& M pfgujmthc cojprgsshof òot wms

pamcgb of gmcn eoot to rgbucg cutmfgous hfput& Ofg pfgujmthc ootwms mttmcngb to tng jovhfi `mr oe tng TRB mfb tng otngr to m stm*thofmry `mr& Rng potgfthma eor hfput eroj tng mftgrhor tnhin cutm*fgous rgcgptors gxhsts shfcg tng mftgrhor tnhin rgsts of tng stmàg.fot jovhfi( ermjg oe tng tgsthfi mppmrmtus& Rng hfput wouabahlgay fggb to `g tnrouin tng strgtcnhfi oe tng bhstma tnhin slhf mstng lfgg hs jovgb! matnouin tnhs hs egat to `g fgiahihàg shfcg tngbhstma ofg*nmae to ofg*tnhrb oe tng tnhin wms fot toucnhfi tng mppm*rmtus&

Rng lfgg wms tgstgb jovhfi hfto eagxhof mfb gxtgfshof erojtwo stmrthfi poshthofs& Rngsg poshthofs wgrg 27 mfb ==4 oelfgg eagxhof& Rngsg stmrthfi poshthofs wgrg cnosgf ms tng jhbbagrmfig oe lfgg jothof .27( wngrg tng cmpsuag! MCA! mfb TCAmrg rgamthvgay rgamxgb! mfb tnus tng poorgst proprhocgpthvg sgf*sory rgsuats snouab `g fotgb& Rnus fo bheegrgfcg snouab gxhst `g*twggf tng hfkurgb mfb ufhfkurgb lfggs& Lfgg eagxhof oe ==4 wms

cnosgf shfcg tgfshof of tng TCA snouab pamy m roag hf proprho*cgpthof! mfb tnus sojg bheegrgfcg hf meegrgft hfput jhint `ghbgfthehgb&

Rwo emjhahmrhty trhma tgsts wgrg pgreorjgb prhor to tng su`kgcts`ghfi àhfbeoabgb mfb nmvhfi m ngmbsgt pamcgb ovgr tng gmrs tofgimtg vhsuma mfb mubhtory cugs& Rgsthfi wms pgreorjgb hf m shfiagsgsshof whtn tgst orbgr oe hfkurgb mfb ufhfkurgb lfgg! stmrthfi posh*thof! mfb bhrgcthof oe jovgjgft `ghfi rmfbojhzgb mfb couftgr*`mamfcgb& Rng TRB tgstgr wms àhfbgb ms to tng forjma mfb TCAhfkurgb lfgg& Hfstrujgft rgahm`hahty wms gstmàhsngb prgvhousay mshftrmcamss corrgamthofs wgrg cmacuamtgb ushfi m ehxgb jobga mfbrmfigb eroj hf vmaug eroj 4&>9 to 4&80&

3==

Ehi&= TRB uthahzgb hf tnhs stuby& Rng TRB rotmtgs tng lfgg hftoeagxhof mfb gxtgfshof tnrouin tng mxhs oe tng kohft& M rotmthofmatrmfsbucgr hftgremcgb whtn m bhihtma jhcroprocgssor couftgr pro*vhbgb tng mfiuamr bhspamcgjgft vmaugs bhrgctay& Rng su`kgct hsprofg& M pfgujmthc cojprgsshof òot hs pamcgb of gmcn eoot to rg*

bucg cutmfgous hfput& Ofg pfgujmthc òot wms mttmcngb to tngjovhfi `mr oe tng TRB! tng otngr to m stmthofmry `mr& Rng su`kgct hsàhfbeoabgb to gahjhfmtg vhsuma cugs& Eor RRBTJ tgsthfi! ngmb*pnofgs whtn wnhtg fohsg mrg usgb to gahjhfmtg mubhtory cugs& Rngsu`kgct snowf scngjmthcmaay hs noabhfi mf of*oee swhtcn ms uthahzgbeor PTT tgsthfi to pmsshvgay rgprobucg tng prgsgftgb mfiag


3/8

Rnrgsnoab to bgtgcthof oe pmsshvg jothof

RRBTJ mssgssjgft wms stmrtgb whtn tng jotor mfb snmet oe tngTRB bhsgfimigb& Su`kgcts wgrg àhfbeoabgb mfb nmb gmrpnofgspamcgb ovgr tnghr gmrs& Rng su`kgct imvg m tnuj`*up shifma to hfbh*cmtg rgmbhfgss to pgreorj tng tgst& Mt m rmfboj pohft burhfi tngsu`sgqugft 04 s lfgg jovgjgft wms gfimigb `y tng tgstgr& Rngsu`kgct bhsgfimigb tng TRB `y prgsshfi m nmfb ngab swhtcn upofpgrcgpthof oe sgfsmthof oe jovgjgft mt tng lfgg& Rng TRB rotmtgbtng lfgg mt m cofstmft mfiuamr vgaochty oe 4&7/s& Rnhs saow spggbwms cnosgf to jhfhjhzg coftrhùthof eroj juscag rgcgptors& Rnrggtrhmas eroj m stmrthfi poshthof oe 27 mfb ==4 lfgg eagxhof jovhfihfto òtn eagxhof mfb gxtgfshof wgrg pgreorjgb& Rng fuj`gr oebgirggs tng TRB jovgb tng lfgg `y tng thjg tng su`kgct bhsgf*imigb tng jotor wms rgcorbgb ms tng RRBTJ& @otn tng hfkurgb mfbufhfkurgb lfggs wgrg tgstgb& Jgmf RRBTJ vmaugs wgrg cmacuamtgbeor tng eour tgst cofbhthofs&

Pgprobucthof oe pmsshvg poshthofhfi

Rng su`kgcts wgrg àhfbeoabgb ùt pgrjhttgb to cojjufhcmtg whtntng TRB tgstgr burhfi PTT tgsthfi& Ms whtn tng RRBTJ tgsthfi!27 mfb ==4 lfgg eagxhof wgrg usgb ms stmrthfi poshthofs .rgegr*gfcg mfiag(& Metgr cofehrjmthof oe tng su`kgcts rgmbhfgss! tng lfgg

wms jovgb pmsshvgay =4 hfto eurtngr eagxhof or gxtgfshof .prg*sgftgb mfiag( `y tng tgstgr& Rng mfiags wgrg prgsgftgb mt vmrhmàgvgaochthgs hf orbgr to rgbucg mfy thjg mssochmtgb cugs& Rng ahj`wms ngab hf tng prgsgftgb mfiag poshthof eor =4 s! mfb tng su`kgctwms mslgb to cofcgftrmtg of tnhs poshthof& Rng ahj` wms tngf rg*turfgb pmsshvgay to tng rgegrgfcg mfiag `y tng gxmjhfgr& Rng su`*kgct wms tngf hfstructgb to jmfhpuamtg tng of/oee swhtcn to rgpro*bucg tng prgvhousay prgsgftgb mfiag mt mf mfiuamr vgaochty oe4&7/s& Rnhs wms rgcorbgb mfb rgpgmtgb eor gmcn oe tng tnrgg trhmasjovhfi hfto eagxhof mfb gxtgfshof& Rng bheegrgfcg `gtwggf tngprgsgftgb mfiag mfb tng mfiag tnmt wms rgposhthofgb `y tng su`kgctwms cmacuamtgb ms tng grror oe rgprobucthof& Rng jgmf oe tnrgg trh*mas wms cmacuamtgb eor tng eour tgst cofbhthofs&

TCA hfkurgb mfb ufhfkurgb lfgg jgmf bheegrgfcgs wgrg mfm*ayzgb ushfi m pmhrgb ttgst eor òtn RRBTJ mfb PTT tgsthfi& Tgmr*sof probuct*jojgft corrgamthof cogeehchgfts wgrg gstmàhsngb `g*

twggf maa bgpgfbgft vmrhmàgs&

Pgsuats

Matnouin maa oe tng pmthgfts cojpamhfgb oe jgcnmfhcmasyjptojs .aoclhfi! ihvhfi wmy( hfhthmaay! tgf .77'( oe tngpmthgfts fotgb sojg hfstm`hahty syjptojs mt eoaaow*up&Fo su`kgcts cojpamhfgb oe aoclhfi oe tng lfgg& Rnhrtggf.90'( cojpamhfgb oe sojg pmhf hf tng lfgg mt eoaaow*up!tng jmkorhty nmvhfi mftgrhor lfgg pmhf& Eour .00'( su`*kgcts nmb hfstm`hahty whtn mcthvhthgs oe bmhay ahvhfi! mfb shxnmb occmshofma ihvhfi*wmy whtn sporthfi mcthvhthgs mt tng

jost rgcgft gvmaumthof& Fhfg .74'( cojpamhfgb oe lfggpmhf or hfstm`hahty iohfi up or bowf stmhrs! mfb shx .33'(cojpamhfgb oe sahint rgcurrgft geeushofs! prhjmrhay whtn mnhin agvga oe mcthvhty& Fhfg .74'( wgrg màg to rgturf totnghr prgvhous agvga oe mcthvhty! hfcaubhfi eour coaag*ihmtg/proegsshofma mtnagtgs&

Of pnyshcma gxmjhfmthof == su`kgcts nmb euaa eagxhofmfb gxtgfshof oe tng meegctgb lfgg& Shx su`kgcts nmb mf mv*grmig 8 aoss oe eagxhof .rmfig 7=0(! mfb ofg amclgb 2oe lfgg nypgrgxtgfshof& Rnrgg su`kgcts nmb m sjmaa geeu*

shof! two nmb trmcg geeushof& Rgf su`kgcts .75'( nmbcrgphtmthof oe tng pmtgaaoegjorma kohft& Rwgavg .59'( nmbtgfbgrfgss oe tng jgbhma emcgt oe tng pmtgaam! mfb shx.33'( nmb tgfbgrfgss oe tng amtgrma emcgt oe tng pmtgaam.eour nmb tgfbgrfgss oe otn tng jgbhma mfb amtgrma emcgts(&Ehetggf .>3'( pmthgfts nmb m irmbg HH postgrhor brmwgr tgstof pnyshcma gxmjhfmthof! wnhag tng rgjmhfhfi tnrgg .=9'(nmb m irmbg 3 postgrhor brmwgr tgst& Rwo su`kgcts nmb jhf*hjma amxhty oe tng jgbhma coaamtgrma ahimjgft .JCA(! wnhagtngrg wms fo otngr ahimjgftous hfkury hbgfthehgb of pnys*hcma gxmjhfmthof .MCA! JCA! ACA! rotmtory hfstm`hahty(oe mfy oe tng su`kgcts&

LR*=444 hfstrujgftgb tgsthfi rgvgmagb mf mvgrmig

9&7 jj .rmfig 0&7=0&7 jj( jmfuma jmxhjuj shbg toshbg bheegrgfcg mt 84 mfb 3&= jj jmfuma jmxhjuj shbgto shbg bheegrgfcg mt 04 oe lfgg eagxhof& Tamhf rmbhoirmpnssnowgb fo bgigfgrmthvg cnmfigs hf mfy oe tng => su`kgcts&Jmifgthc rgsofmfcg hjmihfi oe maa => su`kgcts rgvgmagbmf hsoamtgb TCA tgmr whtn fo jgfhscma or cnofbrma hf*kurhgs&

Eor RRBTJ! stmrthfi mt 27! tng TCA hfkurgb lfggmvgrmigb =&7 4&0! wnhag tng ufhfkurgb lfgg mvgrmigb=&0 4&= .T : 4&47=( ms tng lfgg wms jovhfi hfto gx*tgfshof .Ehi& 0! Rmàg =(& RRBTJ mt 27 jovhfi hftoeagxhof mvgrmigb =&8 4&2 eor tng hfvoavgb lfgg mfb=&0 4&0 eor tng ufhfvoavgb lfgg .T : 4&400< Ehi&0!

Rmàg =(& Mt ==4 RRBTJ vmaugs bhb fot bheegr stmthsth*cmaay shifhehcmftay `gtwggf TCA*hfkurgb mfb forjmalfggs jovhfi hfto eagxhof mfb hfto gxtgfshof .Ehi&3!Rmàg =(&

Rgsthfi PTT mt ==4! tng hfkurgb lfgg mvgrmigb 0&3 4&2 grror eroj tng trug tgst mfiag mfb tng ufhfkurgb lfggmvgrmig 3&= 4&5 grror ms tng tgst mfiag wms `rouint hftojorg gxtgfshof .T : 4&474< Ehi& 2! Rm ag =(& PTT mt ==4tgsthfi hfto eagxhof snowgb mf mvgrmig grror oe 0&0 4&3eor tng hfvoavgb lfgg mfb 3&4 4&2 eor tng ufhfvoavgb

3=0

Hfkurgb Wfhfkurgb Hfkurgb Wfhfkurgb27 Bgirggs*Eagxhof 27 Bgirggs*Gxtgfshof

+ P1 4&47! bgfotg shifhehcmft bheegrgfcg

BgirggsoeTmsshvgjothof0&7

0

=&7

=

4&7

4

Ehi&0 Lhfgstngsthc sgfsmthof ms jgmsurgb `y tng RRBTJ oe tngTCA*hfkurgb mfb forjma coftrmamtgrma lfggs mt tng 27 stmrthfi mf*iag! jovhfi hfto eagxhof mfb gxtgfshof& Lhfgstngshm wms stmthsth*cmaay shifhehcmftay worsg hf tng TCA*hfkurgb lfgg tnmf hf tng ufhf*kurgb lfgg! òtn jovhfi hfto eagxhof mfb jovhfi hfto gxtgfshof


4/8

lfgg .T : 4&474< Ehi&2! Rmàg =(& PTT vmaugs hf 27 bhb fotbheegr shifhehcmftay `gtwggf TCA*bgehchgft mfb forjma lfgg

whtn tng tgst mfiag hf jorg eagxhof or gxtgfshof .Ehi&7!Rmàg =(&M corrgamthof jmtrhx rgvgmagb m shifhehcmft corrgamthof

`gtwggf tng thjg eroj hfkury mfb tng m`hahty to pmsshvgayrgprobucg m kohft mfiag mt ==4 eagxhof jovhfi hfto gxtgf*shof .r: 4&5>9(& Rnus! tng aofigr thjg eroj hfkury! tng`gttgr wms tng su`kgcts PTT& Lfgg amxhty jgmsurgjgfts!ms qumfthehgb `y LR*=444 lfgg ahimjgft mrtnrojgtgr.JgbJgtrhc! Smf Bhgio! Cmahe&! WSM(! wgrg fot corrgamtgbwhtn proprhocgpthvg jgmsurgjgfts&

Bhscusshof

Troprhocgpthof hs cofshbgrgb m spgchmahzgb vmrhmthof oetng sgfsory jobmahty oe toucn mfb gfcojpmssgs tng sgf*smthofs oe kohft jovgjgft .lhfgstngshm( mfb kohft posh*thof .kohft poshthof sgfsg(& Cofschous proprhocgpthof hsgssgfthma eor propgr eufcthof hf mcthvhthgs oe bmhay ahvhfi!

sports! mfb occupmthofma tmsls& Wfcofschous proprhocgp*thof jobuamtgs juscag eufcthof mfb hfhthmtgs rgeagx stm*`hahzmthof& Jucn geeort nms `ggf bgbhcmtgb to gauchbmthfitng jgcnmfhcma eufcthof oe lfgg mrthcuamr structurgs mfbtng corrgspofbhfi jgcnmfhcma bgehchts tnmt occur sgc*ofbmry to bhsrupthof oe tngsg structurgs& Lfgg mrthcuamrstructurgs jmy maso nmvg m shifhehcmft sgfsory eufcthofwnhcn pamys m roag hf byfmjhc kohft stm`hahty! mcutg mfbcnrofhc hfkury! pmtnoaoihcma wgmrhfi! mfb rgnm`hahtmthoftrmhfhfi&

3=3

Rmàg = Bmtm eor gmcn tgsthfi scgfmrho .27! ==4 stmrthfi mfiag!gxtgfshof tgst lfgg jovhfi hfto gxtgfshof! eagxhof tgst lfgg jov*hfi hfto eagxhof(

Rgst Hfkurgb lfgg Wfhfkurgb lfgg T

RRBTJ

27 gxtgfshof =&7= 4&=8 =&=8 4&=4 4&47=

27 eagxhof =&>9 4&37 =&0= 4&00 4&400

PTT

27 gxtgfshof 0&23 4&33 0&97 4&33 4&002

27 eagxhof 0&89 4&29 3&20 4&34 4&=77

RRBTJ

==4 gxtgfshof =&72 4&00 =&23 4&=> 4&==8

==4 eagxhof =&3> 4&02 =&08 4&07 4&084

PTT

==4 gxtgfshof 0&0> 4&39 3&== 4&75 4&474

==4 eagxhof 0&=7 4&0> 0&85 4&35 4&474

RRBTJ vmaugs rgprgsgft tng mvgrmig fuj`gr oe bgirggs .whtnstmfbmrb grror( `georg tng su`kgct sgfsgb tng lfgg jovhfi& PTTvmaugs rgprgsgft tng mvgrmig fuj`gr oe bgirggs grror .whtn stmf*

bmrb grror( oe tng su`kgcts lfgg mfiag eroj tng trug prgsgftgb mf*iag

Hfkurgb Wfhfkurgb Hfkurgb Wfhfkurgb==4 Bgirggs*Eagxhof ==4 Bgirggs*Gxtgfshof


BgirggsoeTmsshvgjothof0&7

0

=&7

=

4&7

4

Ehi&3 Lhfgstngsthc sgfsmthof ms jgmsurgb `y tng RRBTJ oe tngTCA*hfkurgb mfb forjma coftrmamtgrma lfggs mt tng ==4 stmrthfimfiag! jovhfi hfto eagxhof mfb gxtgfshof& Lhfgstngshm wms fot stm*thsthcmaay shifhehcmftay bheegrgft hf tng TCA hfkurgb lfgg tnmf hf tngufhfkurgb lfgg ghtngr jovhfi hfto eagxhof or jovhfi hfto gxtgf*shof

Hfkurgb Wfhfkurgb Hfkurgb Wfhfkurgb==4 Bgirggs*Eagxhof ==4 Bgirggs*Gxtgfshof


Bgirggsoegrror

2

3!7

3

0&7

0

=&7

=4&7

4

Ehi&2 Kohft Toshthof Sgfsg ms jgmsurgb `y PTT oe tng TCA*hf*kurgb mfb forjma coftrmamtgrma lfggs mt tng ==4 stmrthfi mfiag!jovhfi hfto eagxhof mfb gxtgfshof& Kohft poshthof sgfsg wms stmths*thcmaay shifhehcmftay `gttgr hf tng TCA hfkurgb lfgg tnmf hf tng uf*hfkurgb lfgg òtn jovhfi hfto eagxhof mfb jovhfi hfto gxtgfshof

Hfkurgb Wfhfkurgb Hfkurgb Wfhfkurgb27 Bgirggs*Eagxhof 27 Bgirggs*Gxtgfshof


Bgirggsoegrror

2

3!7

3

0&7

0

=&7

=

4&7

4

Ehi&7 Kohft Toshthof Sgfsg ms jgmsurgb `y PTT oe tng TCA*hf*kurgb mfb forjma coftrmamtgrma lfggs mt tng 27 stmrthfi mfiag!

jovhfi hfto eagxhof mfb gxtgfshof& Kohft poshthof sgfsg wms fotstmthsthcmaay shifhehcmftay bheegrgft `gtwggf tng TCA*hfkurgb mfbtng coftrmamtgrma! forjma lfgg! jovhfi hfto eagxhof or jovhfi hftogxtgfshof


5/8

Gxtrhfshc hffgrvmthof oe kohfts eoaaows Nhatofs amw\59Z! wnhcn stmtgs tnmt kohfts mrg hffgrvmtgb `y mrthcuamr`rmfcngs oe tng fgrvgs suppayhfi tng juscags tnmt crosstnmt kohft& Rng meegrgft hffgrvmthof oe kohfts hs `msgb ofpgrhpngrma rgcgptors aocmtgb hf mrthcuamr! juscuamr! mfb cu*tmfgous structurgs& Mrthcuamr rgcgptors hfcaubg fochcgpthvgergg fgrvg gfbhfis mfb proprhocgpthvg jgcnmforgcgptors&

Pueehfh gfbhfis! Tmchfhmf corpuscags! mfb Ioaih tgfboforimfs mrg jgcnmforgcgptors tnmt nmvg ggf nhstojorpno*aoihcmaay hbgfthehgb hf tng MCA \34! 2420! 70! 77! 75Z!TCA \3>! 75Z! jgfhscus \27! 28! 74! 5>Z! amtgrma coaamtgrmaahimjgft \=9Z mfb hfermpmtgaamr emt pmb \23Z&

Jgcnmforgcgptors trmfsbucg sojg eufcthof oe jg*cnmfhcma bgeorjmthof hfto m ergqugfcy jobuamtgb fgurmashifma wnhcn hs trmfsjhttgb vhm corthcma mfb rgeagx pmtn*wmys& Mf hfcrgmsgb sthjuaus oe bgeorjmthof hs cobgb `ymf hfcrgmsgb meegrgft bhscnmrig rmtg or mf hfcrgmsgb popu*amthof oe mcthvmtgb rgcgptors& Irhii mfb Noeejmf \09! 08Znmvg corrgamtgb jgcnmforgcgptor meegrgft bhscnmrig whtnstrmhf gfgriy bgfshty mfb nmvg cmah`rmtgb jgcnmforgcgp*

tors ms hf vhvo aomb cgaas hf tng postgrhor cmpsuag oe tng eg*ahfg lfgg& Pgcgptors bgjofstrmtg bheegrgft mbmpthvg prop*grthgs `msgb of tnghr rgspofsg to m cofthfuous sthjuaus&

]uhcl mbmpthfi .]M( jgcnmforgcgptors! sucn ms tngTmchfhmf corpuscag! bgcrgmsg tnghr bhscnmrig rmtg to gx*thfcthof whtnhf jhaahsgcofbs oe tng ofsgt oe m cofthfuoussthjuaus& Saow*mbmpthfi .SM( jgcnmforgcgptors! sucn mstng Pueehfh gfbhfi mfb tng Ioaih tgfbof orimf! cofthfugtnghr bhscnmrig hf rgspofsg to m cofthfuous sthjuaus& ]Mjgcnmforgcgptors mrg vgry sgfshthvg to cnmfigs hf sthju*amthof mfb mrg tngrgeorg tnouint to jgbhmtg tng sgfsmthofoe kohft jothof& Bheegrgft popuamthofs oe SM jgcnmforg*cgptors mrg jmxhjmaay sthjuamtgb mt spgchehc kohft mfiags!

mfb tnus m cofthfuuj oe SM rgcgptors hs tnouint to jgbh*mtg tng sgfsmthof oe kohft poshthof \=4! 30! 35Z& Hf mfhjmajobgas tngsg jgcnmforgcgptors rgspofb to mcthvg or pms*shvg jothof whtn jmxhjma sthjuamthof occurrhfi mt tng gx*trgjgs oe lfgg jothof \050>! 39Z& Sthjuamthof oe tngsgrgcgptors rgsuats hf rgeagx juscag coftrmcthof mòut tngkohft \5! 04! 37! 54Z&

Rng juscag sphfbag rgcgptor hs m cojpagx eusheorj! SMrgcgptor eoufb whtnhf slgagtma juscag& Uhm meegrgfts mfbgeegrgft to hftrmeusma juscag eh`grs! tng juscag sphfbag rg*cgptor cmf bgtgct mfb rgiuamtg juscag strmhf ovgr m amrigrmfig oe gxtrmeusma juscag agfitn& Rngrg hs cofshbgrmàgbg`mtg ovgr tng rgamthvg coftrhùthof oe juscag rgcgptors

vgrsus kohft rgcgptors to proprhocgpthof! whtn trmbhthofmavhgws gjpnmshzhfi juscag rgcgptors \=4! =2! 0205Z& Pg*cgft worl suiigsts tnmt juscag rgcgptors mfb kohft rgcgp*tors mrg pro`mày cojpagjgftmry cojpofgfts oe mf hftrh*cmtg meegrgft systgj hf wnhcn gmcn rgcgptor jobhehgs tngeufcthof oe tng otngr \5! 0=! 09Z&

Lhfgstngshm hs mssgssgb eufcthofmaay `y jgmsurhfiRRBTJ! mfb kohft poshthof sgfsg `y jgmsurhfi PTT& Hfpmthgfts whtn ufhamtgrma kohft hfvoavgjgft tng coftrmamtgrmalfgg sgrvgs ms mf hftgrfma coftroa! mfb ufhfkurgb lfggs hf

m forjmthvg popuamthof sgrvg ms gxtgrfma coftroas& Wshfitngsg jgmsurgs hf tng lfgg! hfvgsthimtors nmvg eoufb pro*prhocgpthvg bgehchts whtn mihfi \0! 7! 7>Z! mrtnroshs \0! 7!78Z! mfb MCA bhsrupthof \3! 2! 9! =3Z& Rngsg procgssgsbmjmig mrthcuamr structurgs coftmhfhfi jgcnmforgcgptorsmfb mrg tnus nypotngshzgb to rgsuat hf pmrthma bgmeegrgftm*thof whtn rgsuatmft proprhocgpthvg bgehchts& Troprhocgpthvg

gfnmfcgjgft nms ggf eoufb to occur hf maagt bmfcgrs \=Zmfb maso whtn tng usg oe mf gamsthc lfgg saggvg \2! 22Z! sui*igsthfi tnmt trmhfhfi mfb `rmchfi jmy nmvg proprhocgpthvg`gfgehts&

Rng usg oe tng RRBTJ ms m jgmsurg oe lhfgstngshm nms`ggf gstmàhsngb `y prgvhous stubhgs& Saow! pmhfagss! pms*shvg jothof wms usgb hf tnhs hfvgsthimthof! ms tnhs hs tnouintto jmxhjmaay sthjuamtg saow*mbmpthfi kohft jgcnmfo*rgcgptors wnhag jhfhjmaay sthjuamthfi juscag rgcgptors\3Z& Matnouin wg eocusgb prhjmrhay of kohft rgcgptors hfkohft hfkury! juscag rgcgptors mrg mf hftgirma cojpofgft oem cojpagx meegrgft systgj mfb jmy maso pamy m roag hflhfgstngthc mwmrgfgss oe saow! pmsshvg jothof& Hf mbbhthof

to rgeagx pmtnwmys! kohft jgcnmforgcgptors nmvg `ggfsnowf to nmvg corthcma pmtnwmys tnmt mccouft eor cof*schous mpprgchmthof oe kohft jovgjgft mfb poshthof&

Ynhag jucn rgsgmrcn gxhsts mòut MCA bgehchgfcy! hf*caubhfi hfeorjmthof mòut proprhocgpthof hf tng MCA bg*ehchgft lfgg \3! 2! 9! =0! =3! 20! 22Z! bmtm rgimrbhfi TCAhfkurhgs mrg amclhfi \==! 50! 52Z& Yg nmvg stubhgb tng pro*prhocgpthvg eufcthof oe m sgagcthvg iroup oe nujmf su`*kgcts whtn hsoamtgb hfkurhgs to tng TCA& Egw otngr stubhgshbgftheyhfi proprhocgpthvg jgcnmforgcgptors whtnhf tngsu`stmfcg oe tng TCA nmvg mttgjptgb to mssgss tng cahfhcmaeufcthof oe tngsg jgcnmforgcgptors whtnhf tng TCA&

Ofg prgvhous stuby eoufb `gttgr kohft poshthof sgfsg hf

pmthgfts ufbgriohfi totma lfgg mrtnropamsty ushfi m TCArgtmhfhfi prostngshs tnmf whtn m TCA*smcrhehchfi hjpamft\52Z& Kohft poshthof sgfsg wms jgmsurgb `y tng su`kgctsjovhfi m nmfb ngab lfgg jobga to rgpahcmtg tng pgrcghvgbmjouft oe pmsshvgay pamcgb lfgg eagxhof& Rwgfty*ehvgsu`kgcts tgstgb ufbgrwgft m totma lfgg rgpamcgjgft whtn mTCA rgtmhfhfi prostngshs jorg tnmf = ygmr prhor to tgsthfimfb wgrg cojpmrgb whtn fhfg mig*jmtcngb coftroas mfb34 pmthgfts whtn TCA*smcrhehchfi lfgg mrtnropamsthgs \52Z&Nowgvgr! Rhòfg gt ma& \50Z! hf mfotngr TCA proprhocgp*thof rgamtgb stuby! rgportgb fo gagctrojyoirmpnhc bheegr*gfcgs `gtwggf TCA*bgehchgft .sojg whtn postgroamtgrmacorfgr hfkury( mfb TCA*rgcofstructgb lfggs .ushfi jgbhma

ngmb oe tng imstrocfgjhus( burhfi eufcthofma tmsls \50Z&@otn iroups nmb m`forjma ehfbhfis burhfi imht \50Z& Htjmy `g tnmt tnosg whtn TCA rgcofstructhof! wno wgrgquhtg syjptojmthc prgopgrmthvgay! jmy nmvg nmb irgmtgrproprhocgpthvg bgehchts& Rnus tng bhscrgpmfcy ms cojpmrgbwhtn our ehfbhfis jmy `g bug to jmfy posshàg emctorssucn ms fofmfmtojhc rgcofstructhof .jgbhma ngmb oe ims*trocfgjhus ushfi juscags tnmt jmy meegct proprhocgpthvghfput vgrsus our hftrm*mrthcuamr rgcofstructhof oe tng mf*tgroamtgrma ufbag oe tng TCA(! amrig prgopgrmthvg proprho*

3=2


6/8

cgpthvg bgehchts tnmt jmy ofay g hfcojpagtgay rgstorgb! ortnghr tgsthfi protocoa wnhcn hs eufcthofma rgquhrhfi hfputeroj juscag mfb otngr eh`grs ms cojpmrgb whtn our saowjovhfi! pmsshvg jobga&

Ofg puàhsngb stuby jorg shjhamr to ours stubhgb tngtnrgsnoab to bgtgct pmsshvg poshthofhfi hf ghint pmthgftswhtn hsoamtgb TCA bgehchgft lfggs \==Z& Rnghr ghint pm*

thgfts mvgrmigb 32 ygmrs oe mig! sgvgf wgrg jgf! mfb tngmvgrmig thjg eroj hfkury to tgsthfi wms 3 ygmrs .> joftns5 ygmrs(& Rngsg pmthgfts wgrg tgstgb eor RRBTJ mt 4&7/shf tng shtthfi poshthof whtn tnghr lfgg jovgb hfto eagxhoforgxtgfshof eroj 39& Rngsg mutnors eoufb stmthsthcmaayshifhehcmftay agss m`hahty to bgtgct pmsshvg jothof hf tngTCA*hfkurgb lfgg tnmf hf tng forjma! coftrmamtgrma lfgg\==Z& Yg maso eoufb stmthsthcmaay shifhehcmft bheegrgfcgs hftng RRBTJ mt m shjhamr rmfig .27 jovhfi òtn hfto eagx*hof mfb gxtgfshof(! matnouin wg bhb fot ehfb tng rgbucgbRRBTJ mt ==4 oe lfgg eagxhof& Rnhs irgmtgr bgirgg oegxtgfshof wms fot stubhgb `y Camrl gt ma& \==Z! for wmsPTT&

Yg stubhgb tng proprhocgpthvg eufcthof oe m sgagcthvgiroup oe nujmf su`kgcts whtn hsoamtgb hfkurhgs to tng TCA&Rng su`kgcts stubhgb mrg eor tng jost pmrt gxmjpags oe tngcahfhcma `gst*cmsg scgfmrho& Rngsg mrg su`kgcts wno nmvg`ggf trgmtgb fofopgrmthvgay eor hsoamtgb irmbg 0 mfb 3postgrhor amxhty oe tng lfgg& Su`kgcts whtn jorg shifheh*cmft hfkury mrg jorg ahlgay to ufbgrio gmray lfgg ahimjgftrgcofstructhof& Rngrgeorg hfbhvhbumas wno ufbgrio gmrayahimjgft rgcofstructhof jmy `g gxpgctgb to gxnh`ht jorgshifhehcmft proprhocgpthvg bheegrgfcgs&

Troprhocgpthvg bgehchts nmvg `ggf hbgfthehgb hf tngMCA bgehchgft lfgg \3! 22Z& Rngsg proprhocgpthvg aossgsmrg rgbucgb jorg shifhehcmftay mt =7 tnmf mt 27 eagxhof

hf tng MCA*bgehchgft lfgg& Rnhs hs gxpgctgb shfcg tngMCA nms jorg eorcg mt =7 eagxhof mfb tnus jorg hfput hfeufcthofhfi jgcnmforgcgptors& Eurtngr! @mrrgtt \2Z! hf mstuby oe MCA*rgcofstructgb pmthgfts! eoufb pmthgft smths*emcthof mfb eufcthof to `g corrgamtgb whtn proprhocgpthvgeufcthof rmtngr tnmf whtn cahfhcma gxmjhfmthof mfb lfggscorgs&

Yg nmvg snowf tnmt hsoamtgb TCA bgehchgfcy hf tng nu*jmf lfgg bogs rgsuat hf rgbucgb lhfgstngshm! ms tgstgb `ytng tnrgsnoab to bgtgct pmsshvg poshthofhfi mfb gfnmfcgbPTT& Rngrg mrg jmfy potgfthma rgmsofs eor tngsg ehfbhfistnmt mrg `gyofb tng scopg oe tnhs stuby mfb mrg outahfgb`gaow! matnouin ofg potgfthma rgmsof hs tnmt tng proprho*

cgpthvg jgcnmforgcgptors whtnhf tng TCA nmvg sojg cahf*hcma eufcthof& Troprhocgpthvg bgehchts hf stubhgs oe pmthgftswhtn MCA bhsrupthof rgvgma irgmtgr proprhocgpthvgbgehchts! òtn hf jmifhtubg mfb ovgr m irgmtgr rmfig oejothof! tnmf tng ehfbhfis prgsgftgb ngrg eor TCA bgeh*chgfcy&

Ht nms `ggf mriugb tnmt proprhocgpthof jmy pamy m pro*tgcthvg roag hf mcutg hfkury tnrouin rgeagx juscuamr spahft*hfi \22Z& Rng protgcthvg rgeagx mrc hfhthmtgb y jgcnmforg*cgptors mfb juscag sphfbag rgcgptors occurs jucn jorg

quhclay tnmf tng rgeagx mrc hfhthmtgb `y fochcgptors.94=44 j/s vs& = j/s(& Rnus proprhocgpthof jmy pamy mjorg shifhehcmft roag tnmf pmhf sgfsmthof hf prgvgfthfi hf*kury hf tng mcutg sgtthfi& Jorg hjportmftay! proprhocgpthvgbgehchts jmy pamy m jorg shifhehcmft roag hf tng gthoaoiy oecnrofhc hfkurhgs mfb rghfkury& Hfhthma lfgg hfkury rgsuats hfpmrthma bgmeegrgftmthof mfb sgfsory bgehchts wnhcn cmf prg*

bhsposg to eurtngr hfkury \2=Z& Troprhocgpthvg bgehchts jmymaso coftrhùtg to tng gthoaoiy oe bgigfgrmthvg kohft bhs*gmsg tnrouin pmtnoaoihcma wgmrhfi oe m kohft whtn poorsgfsmthof& Ht hs ufcagmr wngtngr tng proprhocgpthvg bgehchtstnmt mccojpmfy bgigfgrmthvg kohft bhsgmsg mrg m rgsuat oetng ufbgrayhfi pmtnoaoihcma procgss or coftrhùtg to tnggthoaoiy oe tng pmtnoaoihcma procgss& Ht jmy `g surjhsgbtngf tnmt tng mppmrgft aoss oe proprhocgpthof ovgr m irgmtgrrmfig oe jothof hf tng MCA bgehchgft lfgg jmy ngap gx*pamhf wny tng so*cmaagb hsoamtgb TCA bgehchgft lfgg nms mrgamthvgay jorg `gfhif coursg&

Rnhs stuby bogs fot mttgjpt to gxpamhf wny RRBTJ hsrgbucgb ofay mt 27! or wny PTT mppgmrs to `g `gttgr mt

==4& Rngrg mrg jmfy posshàg gxpamfmthofs! hfcaubhfi tngmatgrgb lhfgjmthcs oe tng TCA bgehchgft lfgg! vmrhmàg co*orbhfmtgb hfput `gtwggf tng MCA mfb TCA mt vmryhfi bg*irggs oe eagxhof .tng MCA jmy nmvg shifhehcmft rgsuatmfteorcg wngf eagxgb( \53Z! mfb gvgf tnmt tng TCA sthaa cof*trhùtgs proprhocgpthvg hfeorjmthof ms ht jmy ngma hf magfitngfgb poshthof& Eurtngr sthaa! tng geegct oe pnyshcmatngrmpy eoaaowhfi hfkury jmy gfnmfcg proprhocgpthvgeufcthof oe tng rgjmhfhfi jgcnmforgcgptors& Eurtngr! htjmy `g tnmt lhfgstngshm mfb kohft poshthof sgfsg mrg jgbh*mtgb tnrouin bheegrgft pmtnwmys& Yg nypotngshzg tnmt tngmatgrgb proprhocgpthvg hfput hf tng TCA*bgehchgft lfggjmy `g bug to proprhocgpthvg eufcthof oe tng jgcnmforg*

cgptors whtnhf tng TCA! mfb tnmt tngy jmy pamy m roag hftng cahfhcma eufcthof oe pmthgfts whtn TCA hfkurhgs&

Mrgms oe ahjhtmthofs mfb eurtngr stuby hfcaubg tng rgam*thvg hjportmfcg oe coftroa bgshif! geegct oe igfbgr! agfitnoe eoaaow*up! mfb geegct oe pnyshcma tngrmpy& Yg nmvg cno*sgf to usg tng coftrmamtgrma lfgg ms tng coftroa shfcg pro*prhocgpthof nms `ggf snowf to `g meegctgb `y trmhfhfi!mig! hfkury! mfb otngr emctors& Sojg hfvgsthimtors nmvgeoufb aowgr proprhocgpthvg cmpm`hahthgs hf tng fofhfkurgblfggs oe MCA*bgehchgft pmthgfts tnmf hf mig* mfb sgx*jmtcngb coftroas& Ms ufbgrstmfbhfi oe proprhocgpthof hftng nujmf lfgg! mfb spgchehcmaay cruchmtg ahimjgfts! hs hfhts hfemfcy! tng rgamthvg strgfitns mfb ahjhtmthofs oe òtn

jgtnoboaoihgs hs ufcagmr&Rng fuj`gr oe pmthgfts hf our stuby bhb fot maaow stm*thsthcmaay or cahfhcmaay shifhehcmft gvmaumthof oe posshàgigfbgr bheegrgfcgs hf proprhocgpthof eoaaowhfi hsoamtgbTCA bhsrupthof! for eor m jorg jgmfhfieua ufbgrstmfbhfioe tng hfeaugfcg oe thjg of proprhocgpthof eoaaowhfi hso*amtgb TCA tgmrs! matnouin tngsg mrg two oe jmfy hssugstnmt fggbs to `g gvmaumtgb eurtngr hf tng euturg& Eurtngr*jorg! bug to tng rgamthvgay sjmaa fuj`grs oe pmthgfts stub*hgb! m corrgamthof oe pnyshcma tngrmpy whtn outcojg mfb

3=7


7/8

3=5

proprhocgpthof couab fot `g jmbg& Ht bogs mppgmr gvhbgfttnmt m aofigr pgrhob eroj hfkury hs corrgamtgb whtn gf*nmfcgb proprhocgpthof .PTT ofay(& Rnhs jmy `g couftgr*hftuhthvg shfcg tng proposgb fmturma nhstory oe hsoamtgbTCA rupturg hs to bgvgaop bgigfgrmthvg mrtnrhths \=>Z& Ht hslfowf tnmt proprhocgpthof hs rgbucgb hf tng mrtnrhthc lfgg\0! 7! 7>Z& Nowgvgr! our hfvgsthimthof nmb ofay ofg pmthgft

stubhgb fgmray 04 ygmrs eoaaowhfi TCA hfkury! mfb ng nmbfo rmbhoirmpnhc gvhbgfcg oe mrtnrhthc cnmfig! ms whtn maa oetng otngr pmthgfts .pmrt oe tng gxcaushofmry crhtgrhm(& Rnustng hssug oe tng agfitn oe thjg metgr hfkury mfb tng geegctsof proprhocgpthof mrg ufcagmr& Eurtngr hfvgsthimthof whtn

amrigr fuj`grs oe su`kgcts whtn m irgmtgr rmfig oe thjgeroj hfkury to tgsthfi! mfb eurtngr eoaaow*up oe tng su`*kgcts hf tnhs stuby to gvmaumtg proprhocgpthvg cnmfigs hftng smjg hfbhvhbumas ovgr thjg jmy ngap gauchbmtg tng ge*egcts oe thjg of proprhocgpthof&

Mclfowagbigjgfts Rnhs worl wms prgsgftgb mt tng Spgchmaty

Bmy Jggthfi oe tng Mjgrhcmf Ortnopmgbhc Sochgty eor SportsJgbhchfg mfb tng 53rb Mffuma Jggthfi oe tng Mjgrhcmf Mcmbgjyoe Ortnopmgbhc Surigofs! òtn hf Mtamftm! Igorihm! hf Eg`rumry=885& Rng stuby wms pgreorjgb mt tng Fgurojuscuamr PgsgmrcnAmòrmtory! Bgpmrtjgft oe Ortnopmgbhc Surigry! Wfhvgrshty oeThttsùrin! Thttsùrin! Tgff&! WSM&

=&@mrrmcl PA! Slhffgr N@! @rufgt JG!Cool SB .=8>3( Kohft lhfgstngshm hftng nhinay trmhfgb lfgg& K Sports JgbTnys Ehtfgss 02; =>04

0&@mrrmcl PA! Slhffgr N@! Cool SB!

Nmbbmb PK Kr .=8>3( Geegct oe mrthcuamrbhsgmsg mfb totma lfgg mrtnropamsty oflfgg kohft*poshthof sgfsg& K Fguropnys*hoa 74 ;5>25>9

3&@mrrmcl PA! Slhffgr N@! @uclagy SA.=8>8( Kohft proprhocgpthof hf tng mftg*rhor cruchmtg ahimjgft bgehchgft lfgg&Mj K Sports Jgb =9; =5

2&@mrrgtt BS .=88=( Troprhocgpthof mfbeufcthof metgr mftgrhor cruchmtg rgcof*structhof& K @ofg Kohft Suri @r 93;>33>39

7&@mrrgtt BS! Co`` MI! @gftagy I.=88=( Kohft proprhocgpthof hf forjma!ostgomrtnrhthc mfb rgpamcgb lfgg&K @ofg Kohft Suri @r 93; 7375

5&@mxgfbmag PM! Egrrgaa YP! Yoob A.=8>>( Pgspofsgs oe qumbrhcgps jotorufhts to jgcnmfhcma sthjuamthof oe lfggkohft rgcgptors hf tng bgcgrg`rmtg cmt&@rmhf Pgs 273 ; =74=75

9&@gmrb BK! Ly`grb TK! Egriussof CJ!Bobb CME .=883( Troprhocgpthof metgrrupturg oe tng mftgrhor cruchmtg ahim*jgft& Mf o`kgcthvg hfbhcmthof oe tngfggb eor surigry? K @ofg Kohft Suri @r97;3==3=7

>&Cnhcl PP! Kmclsof PY .=89>( Rgmrsoe tng mftgrhor cruchmtg ahimjgft hfyoufi mtnagtgs& K @ofg Kohft Suri Mj54;894893

8&Camfcy YI Kr! Sngaòurfg LB! [ogaa*

fgr I@! Lggfg KS! Pghbgr @! Posgf*`gri RB .=8>3( Rrgmtjgft oe lfggkohft hfstm`hahty sgcofbmry to rupturg oetng postgrhor cruchmtg ahimjgft& K @ofgKohft Suri Mj 57 ; 3=4300

=4&Camrl EK! @urigss TP .=897( Saowaymbmpthfi rgcgptors hf cmt lfgg kohft;cmf tngy shifma kohft mfiag? K Fguro*pnyshoa 3> ; =22>=253

==&Camrl T! JmcBofmab T@! Sutngramfb L.=885( Mfmayshs oe proprhocgpthof hftng postgrhor cruchmtg ahimjgft*bgeh*chgft lfgg& Lfgg Suri Sports Rrmujm*toa Mrtnrosc 2 ; 007009

=0&Co EN! Slhffgr N@! Cmffof YB.=88=( Troprhocgpthof oe tng lfgg eoa*aowhfi MCA rgcofstructhof mfb hts rg*amthof to nggastrhlg hjpuasg& Rrmfsmc*thofs oe tng 39tn Mffuma Jggthfi oetng Ortnopmgbhc Pgsgmrcn Sochgty!Mfmnghj! p 543

=3&Corrhimf KT! Cmnsjmf YE! @rmby JT.=880( Troprhocgpthof hf tng cruchmtgbgehchgft lfgg& K @ofg Kohft Suri @r92; 029074

=2&Cross JJ! JcCaoslgy BH .=893( To*shthof sgfsg eoaaowhfi surihcma rgjovmaoe kohfts hf jmf& @rmhf 77; 223227

=7&Cross JK! Towgaa KE .=8>2( Aofi tgrjeoaaow*up oe postgrhor cruchmtg ahim*

jgft rupturg& M stuby oe ==5 cmsgs&Mj K Sports Jgb =0; 080089=5&Bmfby BK! Tusgy PK .=8>0( Rng aofi*

tgrj rgsuats oe ufrgpmhrgb tgmrs oe tngpostgrhor cruchmtg ahimjgft& K @ofgKohft Suri @r 52; 8082

=9&BgMvham IM! OCoffor @A! UhscoBJ! Shsl RB .=8>8( Rng jgcnmforg*cgptor hffgrvmthof oe tng nujmf ehùamrcoaamtgrma ahimjgft& K Mfmt =50 ; =9

=>&Bgkour N! Ymacn I! Tgyrot K! G`grnmrbT .=8>>( Rng fmturma nhstory oe rupturgoe tng postgrhor cruchmtg ahimjgft& Er KOrtnop Suri 0 ; ==0=04

=8&BuRoht IR .=859( Lfgg kohft cruchmtgahimjgft su`sthtuthof& Rng Ahfbgjmff

.Nghbga`gri( opgrmthof& S Mer K Suri 7;073404&Glnoaj K! Glaufb I! Sloiaufb S

.=854( Of tng rgeagx geegcts eroj tnglfgg kohft oe tng cmt& Mctm TnyshoaScmfb 74 ; =59=92

0=&Egrrgaa YP .=8>7( Rng rgspofsg oesaoway mbmpthfi jgcnmforgcgptors hftng cmt lfgg kohft to tgtmfhc coftrmcthofoe nhfb ahj` juscags& ] K Gxp Tnyshoa94; 339327

00&Eowagr TK! Jgsshgn SS .=8>9( Hsoamtgbpostgrhor cruchmtg ahimjgft hfkurhgs hfmtnagtgs& Mj K Sports Jgb =7 ; 773779

03&Ihovg RT! Jhaagr SK HHH! Lgft @G! Smf*

eorb RA! Imrrhcl KI .=8>3( Fofopgrm*thvg trgmtjgft oe tng torf mftgrhor cru*chmtg ahimjgft& K @ofg Kohft Suri Mj57; =>2=80

02&Ioobwhf IJ! JcCaoslgy BH!Jmttngws T@ .=890( Rng pgrshstgfcgoe mpprgchmàg lhfgstngshm metgr pmrm*ayzhfi kohft meegrgfts ùt prgsgrvhfijuscag meegrgfts& @rmhf Pgs 39 ; 305308

07&Ioobwhf IJ! JcCaoslgy BH!Jmttngws T@ .=890( Rng coftrhùthofoe juscag meegrgfts to lhfgstngshmsnowf `y vh`rmthof hfbucgb haaushofsoe jovgjgft mfb `y tng geegcts oe pmr*mayzhfi kohft meegrgfts& @rmhf 87 ; 947

92>05&Irhii T .=897( Jgcnmfhcma emctors hf*eaugfchfi rgspofsg oe kohft meegrgftfgurofs eroj cmt lfgg& K Fguropnyshoa3>; =293=2>2

09&Irhii T .=895( Pgspofsg oe kohft meegr*gft fgurofs hf cmt jgbhma mrthcuamrfgrvg to mcthvg mfb pmsshvg jovgjgftsoe tng lfgg& @rmhf Pgs ==>; 2>02>7

0>&Irhii T! Noeejmf MN .=8>2( Pueehfhjgcnmforgcgptors hf hsoamtgb kohft cmp*suag; rgspofsgs corrgamtgb whtn strmhfgfgriy bgfshty& Sojmtosgfs Pgs 0;=28=50

08&Irhii T! Noeejmf MN .=8>8( Cmah`rmt*hfi kohft cmpsuag jgcnmforgcgptors ms

hf vhvo soet thssug aomb cgaas& K @ho*jgcn 00 ; 9>=9>734&Nmamtm [! Nmus K .=8>8( Rng uatrmstruc*

turg oe sgfsory fgrvg gfbhfis hf nujmfmftgrhor cruchmtg ahimjgft& Mfmt Gj*`ryoa =98 ;2=720=

3=&Nmwlhfs PK! Jhsmjorg IY! JgrrhttRP .=8>5( Eoaaow up oe tng mcutg fof*opgrmtgb hsoamtgb mftgrhor cruchmtg ahim*jgft tgmr& Mj K Sports Jgb =2 ; 0470=4

Pgegrgfcgs


8/8

3=9

30&Nggtbgrls YK .=89>( Trhfchpma cojpo*fgft mfmayshs oe fgurma popuamthof rg*spofsgs oe lfgg kohft proprhocgptor hfcmt& @rmhf Pgs =75; 7=57

33& Hnmrm N! Fmlmymjm M .=8>5( Byfmjhckohft coftroa trmhfhfi eor lfgg ahimjgfthfkurhgs& Mj K Sports Jgb =2 ; 3483=7

32& Hfsmaa K! Kosgpn BJ! Miahgtth T! Cmjp*`gaa PB .=8>=( @ofg*àocl hahoth`hma*`mfb trmfsegr eor mftgrhor cruchmtg hf*sueehchgfcy& K @ofg Kohft Suri Mj 53;754758

37&Konmfssof N! Skamfbgr T! Soklm T.=884( Mcthvhty hf rgcgptor meegrgftseroj tng mftgrhor cruchmtg ahimjgftgvolgs rgeagx geegcts of eushjotor fgu*rofgs& Fgurosch Pgs > ; 7278

35&Konmfssof N! Skamfbgr T! Soklm T.=88=( Pgcgptors hf tng lfgg kohft ahim*jgfts mfb tnghr roag hf tng `hojgcnmf*hcs oe tng kohft& Crht Pgv @hojgb Gfi=>;32=35>

39&Konmfssof N! Skamfbgr T! Soklm T.=88=( M sgfsory roag eor tng cruchmtgahimjgfts& Cahf Ortnop 05>; =5==9>

3>&Lmtofhs TI! Msshjmlolpouaos MT!Mimphtos JU! Gxmrcnou GH .=88=(Jgcnmforgcgptors hf tng postgrhor cru*chmtg ahimjgft& Nhstoaoihc stuby of cm*bmvgr lfggs& Mctm Ortnop Scmfb 50 ;09509>

38&Lgaagr TJ! Sngaòurfg B! JcCmrroaaKP! Pgtthi MC .=883( Fofopgrmthvgaytrgmtgb hsoamtgb postgrhor cruchmtg ahim*jgft hfkurhgs& Mj K Sports Jgb 0=;=30=35

24&Lgffgby KC! Yghf`gri NY! YhasofMS .=892( Rng mfmtojy mfb eufcthofoe tng mftgrhor cruchmtg ahimjgft ms bg*tgrjhfgb `y cahfhcma mfb jorpnoaoihcmastubhgs& K @ofg Kohft Suri Mj 75;

0030372=&Lgffgby KC! Magxmfbgr HK! Nmygs LC

.=8>0( Fgrvg suppay oe tng nujmflfgg mfb hts eufcthofma hjportmfcg& MjK Sports Jgb =4; 308337

20&Lrmuspg P! Scnjhbt J! Scnmhàg NI.=880( Sgfsory hffgrvmthof oe tng mftg*rhor cruchmtg ahimjgft& Mf gagctropnysh*oaoihcma stuby oe tng rgspofsg oe shfiaghbgfthehgb jgcnmforgcgptors hf tng cmt&K @ofg Kohft Suri Mj 92 ; 384389

23&Lrgff U! Noejmff S! Gfiga M .=884(Ehrst bgscrhpthof oe jgcnmforgcgptorshf tng corpus mbhposuj hfermpmtgaamrgoe jmf& Mctm Mfmt =39 ;=>9=>>

22&Agpnmrt SJ! Locngr JS! Eu EN!@orsm TM! Nmrfgr CB .=880( Troprho*cgpthof eoaaowhfi MCA rgcofstructhof&K Sports Pgnm`ha = ; =>>=85

27&JmcLgfzhg YI! Snhj SS! Bmy @!Agufi I .=8>7( Rng àoob mfb fgrvgsuppay oe tng lfgg jgfhscus hf jmf&Mfmt Pgc 0==; ==7M*==5M

25&JcBmfhga YK! Bmjgrof R@ Kr .=8>4(Rng uftrgmtgb mftgrhor cruchmtg ahim*jgft rupturg& Cahf Ortnop =90; =7>=53

29&Foygs EP! @utagr BA! Tmuaos AG!Iroob GS .=8>3( Hftrm*mrthcuamr cruch*mtg rgcofstructhof& H pgrspgcthvgs ofirmet strgfitn! vmscuamrhzmthof! mfb hj*jgbhmtg jothof metgr rgpamcgjgft& CahfOrtnop =90; 9=99

2>&Foygs EP! Joomr TM! Jmttngws BM!@utagr BA .=8>3( Rng syjptojmthc mf*tgrhor cruchmtg ahimjgft bgehchgft lfgg&H tng aofi*tgrj eufcthofma bhsm`hahty hfmtnagthcmaay mcthvg hfbhvhbumas& K @ofgKohft Suri Mj 57 ; =72=50

28&OCoffor @A .=895( Rng nhstoaoihc

structurg oe boi lfgg jgfhsch whtncojjgft of hts posshàg shifhehcmfcg&Mj K Mfmt =29; 2492=9

74&OCoffor @A! JcCoffmuingy KS.=89>( Rng structurg mfb hffgrvmthof oecmt lfgg jgfhsch mfb tnghr rgamthof to msgfsory nypotngshs oe jgfhscma eufc*thof& Mj K Mfmt =73; 23=220

7=&Tmroahg KJ! @griegab KM .=8>5( Aofi*tgrj rgsuats oe fofopgrmthvg trgmtjgftoe hsoamtgb postgrhor cruchmtg ahimjgfthfkurhgs hf tng mtnagtg& Mj K SportsJgb =2;373>

70&Phvmrb CN! Xmnhm AN! Pnmajh S! Fgw*jmf F .=883( Hjjufonhstocngjhcmabgjofstrmthof oe sgfsory fgrvg eh`grs

mfb gfbhfis hf nujmf mftgrhor cruchmtgahimjgfts& Rrmfsmcthofs oe tng 38tnMffuma jggthfi oe tng Ortnopmgbhc Pg*sgmrcn Sochgty! Smf Ermfchsco! CM!p 5=

73&Smermf JP! Cmabwgaa IA Kr! Eu EN.=882( Troprhocgpthof Cofshbgrmthofshf Surigry& K Sports Pgnm` =; =47==7

72&Smtlu L! Lujmr UT! Fioh SS .=8>5(Mftgrhor cruchmtg ahimjgft hfkurhgs& Rocoufsga or to opgrmtg? K @ofg KohftSuri @r 5> ; 27>25=

77&Scnuatz PM! Jhaagr BC! Lgrr CS!Jhcngah A .=8>2( Jgcnmforgcgptors hfnujmf cruchmtg ahimjgfts; m nhstoaoihcstuby& K @ofg Kohft Suri Mj 55; =490

=49575&Scnuttg JK! Bm`gzhgs GK! [hjfy JA!

Nmppga AR .=8>9( Fgurma mfmtojy oetng nujmf mftgrhor cruchmtg ahimjgft&K @ofg Kohft Suri Mj 58 ; 023029

79&Sngrjmf JE! Ymrrgf PE! Jmrsnmaa KA!Smvmtsly IK .=8>>( M cahfhcma mfb rm*bhoirmpnhcma mfmayshs oe =09 mftgrhorcruchmtg hfsueehchgft lfggs& Cahf Ortnop009;008039

7>&Slhffgr N@! @mrrmcl PA! Cool SB.=8>2( Mig*rgamtgb bgcahfg hf proprho*cgpthof& Cahf Ortnop =>2; 04>0==

78&Slhffgr N@! @mrrmcl PA! Cool SB!Nmbbmb PK Kr .=8>2( Kohft poshthofsgfsg hf totma lfgg mrtnropamsty& K Or*tnop Pgs = ; 0950>3

54&Soklm T! Skoamfbgr T! Konmfssof N!Bkupsko`mclm J .=88=( Hfeaugfcg erojstrgtcn*sgfshthvg rgcgptors hf tng coaamt*grma ahimjgfts oe tng lfgg kohft of tngimjjm*juscag sphfbag systgjs oeeagxor mfb gxtgfsor juscags& FguroschPgs ==; 7750

5=&Sojjgramtn L! Aysnoaj K! Ihaaquhst K.=88=( Rng aofi*tgrj coursg metgrtrgmtjgft oe mcutg mftgrhor cruchmtg ahi*mjgft rupturgs& Mj K Sports Jgb =8;=75=50

50&Rhòfg KG! Mfthcn RK! Tgrry K! Joyfgs

B .=8>>( Eufcthofma mfmayshs oe uf*trgmtgb mfb rgcofstructgb postgrhor cru*chmtg ahimjgft hfkurhgs& Mj K SportsJgb =5 ; 0=9003

53&Rori KS! @mrtof RJ! Tmvaov N! SthfgP .=8>8( Fmturma nhstory oe tng postg*rhor cruchmtg ahimjgft*bgehchgft lfgg&Cahf Ortnop 025; 04>0=5

52&Ymrrgf TK! Oamfaoluf RL! Co ` MI!@gftagy I .=883( Troprhocgpthof metgrlfgg mrtnropamsty& Rng hfeaugfcg oeprostngthc bgshif& Cahf Ortnop 089 ;=>0=>9

57&Ymscngr BC! Jmrloae LA! SnmphroJS! Ehfgrjmf IMJ .=883( Bhrgct hfvhtro jgmsurgjgft oe eorcgs hf tng cru*

chmtg ahimjgfts& H& Rng geegcts oe juath*pamfg aombhfi hf tng hftmct lfgg& K @ofgKohft Suri Mj 97 ; 3993>5

55&Yhaahmjs YK .=8>=( M systgjs*orh*gftgb gvmaumthof oe tng roag oe kohft rg*cgptors mfb otngr meegrgfts hf poshthofmfb jothof sgfsg& Crht Pgv @hojgbGfi 9; 0399

59&Yylg @B .=859( Rng fguroaoiy oekohfts& Mff Poyma Coaa Suri 2= ;0728

5>&[hjfy JA! Ma`rhint BK! Bm`gzhgs G.=8>>( Jgcnmforgcgptors hf tng nujmfjgbhma jgfhscus& Mctm Mfmt =33; 3724

Proprioception in the Posterior Cruciate Lig

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