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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2015

01-09-2015 | Knee

Does concomitant meniscectomy or meniscal repair affect the recovery of quadriceps function post-ACL reconstruction?

Authors: Lindsey K. Lepley, Edward M. Wojtys, Riann M. Palmieri-Smith

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2015

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Abstract

Purpose

The purpose of this study was to determine the effect of concomitant meniscal surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament (ACL) reconstruction.

Methods

Forty-six individuals that were cleared for participation following ACL reconstruction were invited to participate in this study. Participants were placed into groups according to surgical reports (ACL-only, n = 24; meniscal repair, n = 12; meniscectomy, n = 10). Quadriceps strength was quantified using isokinetic and isometric measures. Isokinetic strength was collected at 60°/s in concentric mode. Isometric strength was collected at 90° of knee flexion. Quadriceps activation was assessed using the burst superimposition technique and quantified via the central activation ratio. One-way ANOVAs were utilized to detect whether differences existed in quadriceps activation and strength between groups. Where appropriate, post hoc Bonferroni multiple comparison procedures were used.

Results

Quadriceps activation (P = n.s.) and strength (isokinetic: P = n.s.; isometric: P = n.s.) were not different between groups.

Conclusion

Concomitant meniscectomy or meniscal repair did not affect the recovery of quadriceps activation and strength at a time when individuals return to sport following ACL reconstruction. Though group differences in quadriceps function were not detected, all participants demonstrated levels of quadriceps activation failure that are below healthy individuals at a time when they were returned to sport. Given that persistent quadriceps activation failure is detrimental to knee function, rehabilitation protocols that target quadriceps activation failure should be developed and employed post-reconstruction.

Level of evidence

III.
Appendix
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Literature
1.
Becker R, Berth A, Nehrig M, Awiszus F (2004) Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. J Orthop Res 22:768–773CrossRefPubMed
2.
Chmielewski TL, Stackhouse S, Axe MJ, Snyder-Mackler L (2004) A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament rupture. J Orthop Res 22(5):925–930CrossRefPubMed
3.
Cohen J (1977) Statistical analysis for the behavioral sciences. Academic Press, New York
4.
Eitzen I, Risberg MA, Holm I (2009) Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. Br J Sports Med 43(5):371–376CrossRefPubMed
5.
Gray JC (1999) Neural and vascular anatomy of the menisci of the human knee. J Orthop Sports Phys Ther 29(1):23–30CrossRefPubMed
6.
7.
Hopkins JT, Ingersoll CD (2000) Arthrogenic muscle inhibition: a limiting factor in joint rehabilitation. J Sport Rehabil 9:135–159
8.
Hurley MV, Jones DW, Newham DJ (1994) Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clin Sci (Colch) 86(3):305–310CrossRef
9.
Jerosch J, Prymka M, Castro WH (1996) Proprioception of knee joints with a lesion of the medial meniscus. Acta Orthop Belg 62(1):41–45PubMed
10.
Kent-Braun JA, Le Blanc R (1996) Quantitation of central activation failure during maximal voluntary contractions in humans. Muscle Nerve 19(7):861–869CrossRefPubMed
11.
12.
Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50(10):3145–3152CrossRefPubMed
13.
14.
Musahl V, Jordan SS, Colvin AC, Tranovich MJ, Irrgang JJ, Harner CD (2010) Practice patterns for combined anterior cruciate ligament and meniscal surgery in the United States. Am J Sports Med 38(5):918–923CrossRefPubMed
15.
Øiestad BE, Holm I, Aune AK, Gunderson R, Myklebust G, Engebretsen L, Fosdahl MA, Risberg MA (2010) Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction a prospective study with 10 to 15 years of follow-up. Am J Sports Med 38(11):2201–2210CrossRefPubMed
16.
Palmieri-Smith RM, Thomas AC (2009) A Neuromuscular mechanism of posttraumatic osteoarthritis associated with ACL injury. Exerc Sport Sci Rev 37(3):147–153CrossRefPubMed
17.
Palmieri-Smith RM, Thomas AC, Karvonen-Gutierrez C, Sowers MF (2010) A clinical trial of neuromuscular electrical stimulation in improving quadriceps muscle strength and activation among women with mild and moderate osteoarthritis. Phys Ther 90(10):1441–1452CrossRefPubMed
18.
Palmieri-Smith RM, Thomas AC, Wojtys EM (2008) Maximizing quadriceps strength after ACL reconstruction. Clin Sports Med 27(3):405–424CrossRefPubMed
19.
Rice DA, McNair PJ (2010) Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum 40(3):250–266CrossRefPubMed
20.
Shelbourne KD, Gray T (2000) Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med 28(4):446–452PubMed
21.
Snyder-Mackler L, De Luca PF, Williams PR, Eastlack ME, Bartolozzi AR 3rd (1994) Reflex inhibition of the quadriceps femoris muscle after injury or reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 76(4):555–560PubMed
22.
Snyder-Mackler L, Delitto A, Stralka S, Balley SL (1994) Use of electrical stimulation to enhance recovery of quadriceps femoris muscle force production in patients following anterior cruciate ligament reconstruction. Phys Ther 74(10):901–907PubMed
23.
Stokes M, Young A (1984) The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci (Colch) 67(1):7–14CrossRef
24.
Tourville TW, Jarrell KM, Naud S, Slauterbeck JR, Johnson RJ, Beynnon BD (2014) Relationship between isokinetic strength and tibiofemoral joint space width changes after anterior cruciate ligament reconstruction. Am J Sports Med 42(2):302–311CrossRefPubMed
25.
Wilk KE, Macrina LC, Cain EL, Dugas JR, Andrews JR (2012) Recent advances in the rehabilitation of anterior cruciate ligament injuries. J Orthop Sports Phys Ther 42(3):153–171CrossRefPubMed
Metadata
Title
Does concomitant meniscectomy or meniscal repair affect the recovery of quadriceps function post-ACL reconstruction?
Authors
Lindsey K. Lepley
Edward M. Wojtys
Riann M. Palmieri-Smith
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3093-3

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