Association between individual quadriceps muscle volume/enthesis and patello femoral joint cartilage morphology

Abstract

IntroductionThe aim of this study was to determine the association between individual quadriceps muscle volumes and the quadriceps enthesis structures and cartilage morphology at the patellofemoral joint (PFJ).MethodsWe studied 12 cadavers (age 75 ± 5 years). For both legs, individual quadriceps muscles (vastus lateralis (VL), rectus femoris (RF), vastus intermedialis (VI) and vastus medialis (VM)) were dissected and their volumes measured. Cartilage areas at the PFJ were classified using the International Cartilage Repair Society (ICRS) score. Histological sections were evaluated at the quadriceps tendon enthesis (laterally, centrally and medially). Several variables were calculated on the binary images based on two-dimensional analysis. These were apparent bone area (BA) and apparent trabecular thickness (TH). A Spearman rank test was used to determine the strength of correlation between individual quadriceps muscles volume, the structure of the quadriceps tendon enthesis and the ICRS score.ResultsThe thickness of calcified fibrocartilage tissue was significantly greater in the central part of the enthesis than both medially (P = 0.03) and laterally (P = 0.04). Uncalcified fibrocartilage was significantly thicker laterally (P = 0.04) and centrally (P = 0.02) than medially. Muscle volume was highest (P <0.05) for the VL, followed by the VI, VM and RF. There was no association between total and individual muscle volumes and ICRS or BA. However, there was a strong positive correlation (r = 0.81) between the VL/VM volume ratio and BA ratio (bone volume at the lateral part divided by bone volume at the medial part). There was a moderate positive correlation between VL/VM and ICRS (r = 0.65) and between ICRS and BA ratio (lateral/medial; r = 0.74).ConclusionsIndividual and total quadriceps volumes were not correlated with cartilage loss at the PFJ or fibrocartilage thickness. However, both VL/VM and BA ratio (lateral/medial) were positively correlated with ICRS scoring and therefore could be a tool for predicting degree of PFJ osteoarthritis severity.

Quadriceps function relates to muscle size following ACL reconstruction

“…Persistent quadriceps atrophy, quadriceps muscle dysfunction, and reduced knee related function have been consistently reported following ACLR. To our knowledge, this is the first investigation that has addressed the relationship between the volume and CSA of individual quadriceps muscles with measures of quadriceps function and self‐reported function in those with a history of ACLR.…”

“…It is not clear if persistent quadriceps weakness and reduced quadriceps activation following ACLR are related to changes in muscle size or more complex neural adaptations. In populations such as patients with patellofemoral joint osteoarthritis, direct relationships between quadriceps muscle volume, quadriceps function, and patient reported outcomes have been reported; however, these relationships have been limited to assessments of total quadriceps muscle group characteristics . More detailed understanding of the relationship between individual quadriceps muscle cross‐sectional area (CSA) or volume and function may aid clinicians in better evaluating and treating patients with the goal of maximizing both short‐term and long‐term outcomes.…”

Quickly progressive amyotrophy of the thigh: An unusual cause of rapid chondrolysis of the knee

“…Reduced quadriceps strength or volume is associated with patello-femoral osteoarthritis (OA) [1,2]. Rapidly destructive OA is a recognized entity in hip but may occur in knee OA [3].…”

Repetitive vascular occlusion stimulus (RVOS) versus standard care to prevent muscle wasting in critically ill patients (ROSProx):a study protocol for a pilot randomised controlled trial

“…Repeated inflation/deflation of a blood pressure cuff around a limb to above arterial pressure (~ 200 mmHg) elicits brief bouts (~ 5 min) of limb ischaemia/reperfusion [43]. In healthy subjects, RVOS can improve exercise performance [44–47], whilst vascular occlusion during low-intensity exercise (blood flow restriction exercise) can enhance hypertrophic and strength responses in skeletal muscle [48] of healthy controls [49–52], athletes [53] and the elderly [54–60], and seems to improve physical function and health-related quality of life in patients with inflammatory muscle disease [61–63]. Moreover, RVOS may mitigate against atrophy induced by immobilisation and unloading: patients recovering from ligament reconstruction surgery who received two sessions of RVOS (five cycles of vascular occlusion for 5 min and release for 3 min) to the proximal thigh daily for > 10 days after surgery had 50% less disuse knee extensor muscles mass loss [43].…”

“…Amongst 12,642 recipients (including healthy subjects, older subjects and individuals with clinical conditions), attributable serious side effects were few: venous thrombus (0.055%), pulmonary embolism (0.008%) and rhabdomyolysis (0.008%) [92]. No negative impact on haemodynamic, haemostatic and inflammatory responses has been observed in healthy young, older and clinical populations [61, 93–95]. In addition to being safe, RVOS also appears well tolerated, with a pain score of 3.6 ± 3.4 (mean ± SD) out of 10 during application to the lower limb in patients with aneurysmal subarachnoid haemorrhage [96].…”