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Published in: Archives of Orthopaedic and Trauma Surgery 8/2009

01-08-2009 | Arthroscopy and Sports Medicine

Measurements of the quadriceps femoris function after meniscus refixation at the stable athlete’s knee

Authors: T. Stein, A. P. Mehling, K. Jost, T. C. Auhuber, A. Jäger

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2009

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Abstract

Introduction

The purpose of this study was to monitor the muscular changes regarding the isokinetic strength and torque pattern of the quadriceps femoris at the stable athlete’s knee after meniscus tear refixation.

Materials and methods

Therefore 15 athletes (10 male, 5 female) performing recreational or competitional sports at least five times a week before injury were retrospectively examined in the average 2.5 years after isolated arthroscopic meniscus refixation using Inside Out technique. Next to function and sport activity focused scores the isokinetic peak torque (PT) and in the EMG have been analyzed compared to the uninjured knee.

Results

The mean age was 31.26 years. The time between injury and surgery was in the average 13.7 days. According to our first results the data suggest a complete recovery of functional and muscular pattern after meniscus refixation at the stable athlete’s knee. No significant EMG changes for quadriceps femoris were detectable. The PT was fully recovered. The functional and sport activity score analysis (Lysholm and Tegner score) showed no changes in the postoperative long-term follow up compared to the preinjured status.

Conclusion

Examining isokinetic PT and the EMG of the quadriceps femoris, these data show no side-to-side differences. Regarding the function and sports activity score system, the functionally high demand patients seem to profit by this procedure.
Literature
1.
go back to reference Barber FA, Herbert MA (2000) Meniscal repair devices. Arthroscopy 16:613–618PubMed Barber FA, Herbert MA (2000) Meniscal repair devices. Arthroscopy 16:613–618PubMed
2.
go back to reference Becker R, Berth A, Nehring M, Awiszus F (2004) Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. J Orthop Res 22:768–773PubMedCrossRef Becker R, Berth A, Nehring M, Awiszus F (2004) Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. J Orthop Res 22:768–773PubMedCrossRef
3.
go back to reference Becker R, Brettschneider O, Grobel KH, von Versen R, Starke C (2006) Distraction forces on repaired bucket-handle lesions in the medial meniscus. Am J Sports Med 34:1941–1947PubMedCrossRef Becker R, Brettschneider O, Grobel KH, von Versen R, Starke C (2006) Distraction forces on repaired bucket-handle lesions in the medial meniscus. Am J Sports Med 34:1941–1947PubMedCrossRef
4.
go back to reference Borner CE, Ruhmann O, Hehl S, Wirth CJ, Bohnsack M (2005) Treatment of incomplete meniscal lesions in athletes. Sportverletz Sportschaden 19:200–204PubMedCrossRef Borner CE, Ruhmann O, Hehl S, Wirth CJ, Bohnsack M (2005) Treatment of incomplete meniscal lesions in athletes. Sportverletz Sportschaden 19:200–204PubMedCrossRef
5.
go back to reference Courtney CA, Rine RM (2006) Central somatosensory changes associated with improved dynamic balance in subjects with anterior cruciate ligament deficiency. Gait Posture 24:190–195PubMedCrossRef Courtney CA, Rine RM (2006) Central somatosensory changes associated with improved dynamic balance in subjects with anterior cruciate ligament deficiency. Gait Posture 24:190–195PubMedCrossRef
6.
go back to reference DeHaven KE, Black KP, Griffiths HJ (1989) Open meniscus repair. Technique and two to nine year results. Am J Sports Med 17:788–795PubMedCrossRef DeHaven KE, Black KP, Griffiths HJ (1989) Open meniscus repair. Technique and two to nine year results. Am J Sports Med 17:788–795PubMedCrossRef
7.
go back to reference DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530PubMedCrossRef DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530PubMedCrossRef
8.
go back to reference Drechsler WI, Cramp MC, O.M. S (2006) Changes in muscle strength and EMG median frequency after anterior cruciate ligament reconstruction. Eur J Appl Physiol 98:613-623 Drechsler WI, Cramp MC, O.M. S (2006) Changes in muscle strength and EMG median frequency after anterior cruciate ligament reconstruction. Eur J Appl Physiol 98:613-623
9.
go back to reference Durand A, Richards CL, Malouin F (1991) Strength recovery and muscle activation of the knee extensor and flexor muscles after arthroscopic meniscectomy. A pilot study. Clin Orthop Relat Res 262:210–226PubMed Durand A, Richards CL, Malouin F (1991) Strength recovery and muscle activation of the knee extensor and flexor muscles after arthroscopic meniscectomy. A pilot study. Clin Orthop Relat Res 262:210–226PubMed
10.
go back to reference Durselen L, Schneider J, Galler M, Claes LE, Bauer G (2003) Cyclic joint loading can affect the initial stability of meniscal fixation implants. Clin Biomech (Bristol, Avon) 18:44-49 Durselen L, Schneider J, Galler M, Claes LE, Bauer G (2003) Cyclic joint loading can affect the initial stability of meniscal fixation implants. Clin Biomech (Bristol, Avon) 18:44-49
11.
go back to reference Dye SF, Wojtys EM, Fu FH, Fithian DC, Gillquist I (1999) Factors contributing to function of the knee joint after injury or reconstruction of the anterior cruciate ligament. Instr Course Lect 48:185–198PubMed Dye SF, Wojtys EM, Fu FH, Fithian DC, Gillquist I (1999) Factors contributing to function of the knee joint after injury or reconstruction of the anterior cruciate ligament. Instr Course Lect 48:185–198PubMed
12.
go back to reference Ellermann A, Bülow JU, Siebold R, Bös L (2001) Expertenmeinung: Meniskusrefixation. Arthroskopie 14:278–279 Ellermann A, Bülow JU, Siebold R, Bös L (2001) Expertenmeinung: Meniskusrefixation. Arthroskopie 14:278–279
13.
go back to reference Elmqvist LG, Lorentzon R, Johansson C, Fugl-Meyer AR (1988) Does a torn anterior cruciate ligament lead to change in the central nervous drive of the knee extensors? Eur J Appl Physiol Occup Physiol 58:203–207PubMedCrossRef Elmqvist LG, Lorentzon R, Johansson C, Fugl-Meyer AR (1988) Does a torn anterior cruciate ligament lead to change in the central nervous drive of the knee extensors? Eur J Appl Physiol Occup Physiol 58:203–207PubMedCrossRef
14.
go back to reference Ericsson YB, Roos EM, Dahlberg L (2006) Muscle strength, functional performance, and self-reported outcomes four years after arthroscopic partial meniscectomy in middle-aged patients. Arthritis Rheum 55:946–952PubMedCrossRef Ericsson YB, Roos EM, Dahlberg L (2006) Muscle strength, functional performance, and self-reported outcomes four years after arthroscopic partial meniscectomy in middle-aged patients. Arthritis Rheum 55:946–952PubMedCrossRef
15.
go back to reference Fink C (2001) Meniskusrefixation–Anatomische und biologische Grundlagen. Arthroskopie 14:248–253CrossRef Fink C (2001) Meniskusrefixation–Anatomische und biologische Grundlagen. Arthroskopie 14:248–253CrossRef
16.
go back to reference Freiwald J, Jäger A, Starker M (1993) EMG-assisted functional analysis within the scope of follow-up of arthroscopically managed injuries of the anterior cruciate ligament. Sportverletz Sportschaden 7:122–128PubMedCrossRef Freiwald J, Jäger A, Starker M (1993) EMG-assisted functional analysis within the scope of follow-up of arthroscopically managed injuries of the anterior cruciate ligament. Sportverletz Sportschaden 7:122–128PubMedCrossRef
17.
go back to reference Gapeyeva H, Paasuke M, Ereline J, Pintsaar A, Eller A (2000) Isokinetic torque deficit of the knee extensor muscles after arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc 8:301–304PubMedCrossRef Gapeyeva H, Paasuke M, Ereline J, Pintsaar A, Eller A (2000) Isokinetic torque deficit of the knee extensor muscles after arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc 8:301–304PubMedCrossRef
18.
go back to reference Haas AL, Schepsis AA, Hornstein J, Edgar CM (2005) Meniscal repair using the FasT-Fix all-inside meniscal repair device. Arthroscopy 21:167–175PubMedCrossRef Haas AL, Schepsis AA, Hornstein J, Edgar CM (2005) Meniscal repair using the FasT-Fix all-inside meniscal repair device. Arthroscopy 21:167–175PubMedCrossRef
19.
go back to reference Herzog W, Suter E (1997) Muscle inhibition following knee injury and disease. Sportverletz Sportschaden 11:74–78PubMedCrossRef Herzog W, Suter E (1997) Muscle inhibition following knee injury and disease. Sportverletz Sportschaden 11:74–78PubMedCrossRef
20.
go back to reference Hurley MV, Jones DW, Newham DJ (1994) Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clin Sci (Lond) 86:305–310 Hurley MV, Jones DW, Newham DJ (1994) Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clin Sci (Lond) 86:305–310
21.
go back to reference Jäger A, Khoudeir S, Braune C, Herresthal J (2002) Can meniscal suture repair in athletes prevent early development of osteoarthritis without compromising the preinjury sports activity level. Sportverletz Sportschaden 16:70–73PubMedCrossRef Jäger A, Khoudeir S, Braune C, Herresthal J (2002) Can meniscal suture repair in athletes prevent early development of osteoarthritis without compromising the preinjury sports activity level. Sportverletz Sportschaden 16:70–73PubMedCrossRef
22.
go back to reference Jerosch J, Riemer S (2004) How good are clinical investigative procedures for diagnosing meniscus lesions? Sportverletz Sportschaden 18:59–67PubMedCrossRef Jerosch J, Riemer S (2004) How good are clinical investigative procedures for diagnosing meniscus lesions? Sportverletz Sportschaden 18:59–67PubMedCrossRef
23.
go back to reference Kannus P, Jarvinen M (1989) Incidence of knee injuries and the need for further care. A one-year prospective follow-up study. J Sports Med Phys Fitness 29:321–325PubMed Kannus P, Jarvinen M (1989) Incidence of knee injuries and the need for further care. A one-year prospective follow-up study. J Sports Med Phys Fitness 29:321–325PubMed
24.
go back to reference Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef
25.
go back to reference Matthews P, St-Pierre DM (1996) Recovery of muscle strength following arthroscopic meniscectomy. J Orthop Sports Phys Ther 23:18–26PubMed Matthews P, St-Pierre DM (1996) Recovery of muscle strength following arthroscopic meniscectomy. J Orthop Sports Phys Ther 23:18–26PubMed
26.
go back to reference McHugh MP, Tyler TF, Browne MG, Gleim GW, Nicholas SJ (2002) Electromyographic predictors of residual quadriceps muscle weakness after anterior cruciate ligament reconstruction. Am J Sports Med 30:334–339PubMed McHugh MP, Tyler TF, Browne MG, Gleim GW, Nicholas SJ (2002) Electromyographic predictors of residual quadriceps muscle weakness after anterior cruciate ligament reconstruction. Am J Sports Med 30:334–339PubMed
27.
go back to reference Mikkelsen C, Werner S, Eriksson E (2000) Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc 8:337–342PubMedCrossRef Mikkelsen C, Werner S, Eriksson E (2000) Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc 8:337–342PubMedCrossRef
28.
go back to reference Moffet H, Richards CL, Malouin F, Bravo G, Paradis G (1998) Effects of the type of meniscal lesion on knee function. J Electromyogr Kinesiol 8:411–422PubMedCrossRef Moffet H, Richards CL, Malouin F, Bravo G, Paradis G (1998) Effects of the type of meniscal lesion on knee function. J Electromyogr Kinesiol 8:411–422PubMedCrossRef
29.
go back to reference Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–638PubMedCrossRef Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–638PubMedCrossRef
30.
go back to reference Morrissey MC, Hooper DM, Drechsler WI, Hill HJ (2004) Relationship of leg muscle strength and knee function in the early period after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 14:360–366PubMedCrossRef Morrissey MC, Hooper DM, Drechsler WI, Hill HJ (2004) Relationship of leg muscle strength and knee function in the early period after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 14:360–366PubMedCrossRef
31.
go back to reference Muellner T, Egkher A, Nikolic A, Funovics M, Metz V (1999) Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years. Am J Sports Med 27:16–20PubMed Muellner T, Egkher A, Nikolic A, Funovics M, Metz V (1999) Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years. Am J Sports Med 27:16–20PubMed
32.
go back to reference Pujol N, Panarella L, Selmi TA, Neyret P, Fithian D, Beaufils P (2008) Meniscal healing after meniscal repair: a CT arthrography assessment. Am J Sports Med 36:1489–1495PubMedCrossRef Pujol N, Panarella L, Selmi TA, Neyret P, Fithian D, Beaufils P (2008) Meniscal healing after meniscal repair: a CT arthrography assessment. Am J Sports Med 36:1489–1495PubMedCrossRef
33.
go back to reference Rupp S, Seil R, Kohn D (2001) Ergebnisse nach Meniskusnaht—Literaturübersicht. Arthroskopie 14:267–275CrossRef Rupp S, Seil R, Kohn D (2001) Ergebnisse nach Meniskusnaht—Literaturübersicht. Arthroskopie 14:267–275CrossRef
34.
go back to reference Stam HJ, Binkhorst RA, Kuhlmann P, van Nieuwenhuyzen JF (1992) Clinical progress and quadriceps torque ratios during training of meniscectomy patients. Int J Sports Med 13:183–188PubMedCrossRef Stam HJ, Binkhorst RA, Kuhlmann P, van Nieuwenhuyzen JF (1992) Clinical progress and quadriceps torque ratios during training of meniscectomy patients. Int J Sports Med 13:183–188PubMedCrossRef
35.
go back to reference Swenson TM, Fu FH (1993) Anterior cruciate ligament reconstruction: long-term results using autograft tissue. Clin Sports Med 12:709–722PubMed Swenson TM, Fu FH (1993) Anterior cruciate ligament reconstruction: long-term results using autograft tissue. Clin Sports Med 12:709–722PubMed
36.
go back to reference Tandogan RN, Taser O, Kayaalp A, Taskiran E, Pinar H, Alparslan B, Alturfan A (2004) Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc 12:262–270PubMedCrossRef Tandogan RN, Taser O, Kayaalp A, Taskiran E, Pinar H, Alparslan B, Alturfan A (2004) Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc 12:262–270PubMedCrossRef
37.
go back to reference Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49 Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
38.
go back to reference Tuckman DV, Bravman JT, Lee SS, Rosen JE, Sherman OH (2006) Outcomes of meniscal repair: minimum of 2-year follow-up. Bull Hosp Jt Dis 63:100–104PubMed Tuckman DV, Bravman JT, Lee SS, Rosen JE, Sherman OH (2006) Outcomes of meniscal repair: minimum of 2-year follow-up. Bull Hosp Jt Dis 63:100–104PubMed
39.
go back to reference Urbach D, Nebelung W, Weiler HT, Awiszus F (1999) Bilateral deficit of voluntary quadriceps muscle activation after unilateral ACL tear. Med Sci Sports Exerc 31:1691–1696PubMedCrossRef Urbach D, Nebelung W, Weiler HT, Awiszus F (1999) Bilateral deficit of voluntary quadriceps muscle activation after unilateral ACL tear. Med Sci Sports Exerc 31:1691–1696PubMedCrossRef
40.
go back to reference Urbach D, Nebelung W, Roepke M, Becker R, Awiszus F (2000) Bilateral dysfunction of the quadriceps muscle after unilateral cruciate ligament rupture with concomitant injury central activation deficit. Unfallchirurg 103:949–955PubMedCrossRef Urbach D, Nebelung W, Roepke M, Becker R, Awiszus F (2000) Bilateral dysfunction of the quadriceps muscle after unilateral cruciate ligament rupture with concomitant injury central activation deficit. Unfallchirurg 103:949–955PubMedCrossRef
41.
go back to reference Venkatachalam S, Godsiff SP, Harding ML (2001) Review of the clinical results of arthroscopic meniscal repair. Knee 8:129–133PubMedCrossRef Venkatachalam S, Godsiff SP, Harding ML (2001) Review of the clinical results of arthroscopic meniscal repair. Knee 8:129–133PubMedCrossRef
Metadata
Title
Measurements of the quadriceps femoris function after meniscus refixation at the stable athlete’s knee
Authors
T. Stein
A. P. Mehling
K. Jost
T. C. Auhuber
A. Jäger
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-009-0852-6

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