Association of Quadriceps Strength Symmetry and Surgical Status With Clinical Osteoarthritis Five Years After Anterior Cruciate Ligament Rupture

Arhos, Elanna K; Thoma, Louise M.; Grindem, Hege; Logerstedt, David; Risberg, May Arna; Snyder‐Mackler, Lynn

doi:10.1002/acr.24479

Cited by 33 publications

(16 citation statements)

References 32 publications

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“…In line with our findings, previous studies report associations between quadriceps femoris weakness and joint degeneration following ACL reconstruction. Arhos et al 41 demonstrated an association between more symmetrical quadriceps femoris strength and lower odds of clinical knee OA within 5 years of ACL injury or reconstruction. Between 2 and 4 years post‐ACL reconstruction, poorer quadriceps femoris strength was associated with more severe patellofemoral cartilage damage during a second‐look arthroscopy 42 .…”

Section: Discussionmentioning

confidence: 99%

Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

Brunst

Ithurburn

Zbojniewicz

et al. 2021

Journal Orthopaedic Research

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Quadriceps femoris strength asymmetry at the time of return to sports participation after anterior cruciate ligament (ACL) reconstruction contributes to worse function and asymmetric landing patterns, but the impact on longitudinal outcomes is not known. This study determined if young athletes after ACL reconstruction with quadriceps femoris strength asymmetry at a return to sports clearance would demonstrate markers of knee cartilage degeneration 5 years later compared to those with symmetric quadriceps femoris strength at return to sports. Participants (n = 27) were enrolled at the time of medical clearance for sports participation (baseline testing) and followed for 5 years. At baseline, quadriceps femoris strength was measured bilaterally and a limb symmetry index was used to divide the cohort into two groups: return to sport clearance with high quadriceps femoris strength (RTS‐HQ; limb symmetry index ≥ 90%) and return to sport clearance with low quadriceps femoris strength (RTS‐LQ; limb symmetry index < 85%). At 5 years post‐baseline, quantitative magnetic resonance imaging (T2 relaxation times (ms): involved knee medial/lateral femoral condyle and tibial plateau) data were collected. Group differences were evaluated with independent samples t tests. At 5 years post‐return to sports, the RTS‐LQ strength group (n = 14) demonstrated elevated T2 relaxation times at the anterior region of the lateral femoral condyle compared to the RTS‐HQ strength group (n = 13). Clinical Significance: Just over 50% of this cohort was cleared for sports participation with involved limb quadriceps femoris strength deficits that may contribute to early markers of knee cartilage degeneration within the subsequent 5 years.

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Section: Discussionmentioning

confidence: 99%

Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

Brunst

Ithurburn

Zbojniewicz

et al. 2021

Journal Orthopaedic Research

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“…The Luyten original KOOS criterion operationally defines a participant as having early knee OA illness if they score ≤85% on at least 2 of the following 4 KOOS subscales: symptoms, pain, QoL, or ADL (Table 1) (10). The Luyten original KOOS criterion omits the KOOS sport subscale in the early OA illness definition and has been used to define early knee OA illness in a previous study of people post-ACLR (21).…”

Section: Koosmentioning

confidence: 99%

“…Even though these KOOS criteria were not developed for patients with ACLR, the Luyten and Englund KOOS criteria have been applied to patients with ACLR. Furthermore, these criteria are often interpreted to represent early OA illness among patients post-ACLR (20)(21)(22). However, the differences in the subscale thresholds and the number of subscales used to define each criterion indicate that meeting the Luyten versus the Englund KOOS criteria may represent varying levels of symptom burden in patients post-ACLR (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Early Knee Osteoarthritis Illness Among Various Patient‐Reported Classification Criteria After Anterior Cruciate Ligament Reconstruction

Harkey

Baez

Lewis

et al. 2022

Arthritis Care & Research

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Objective. To compare the prevalence of participants meeting different patient-reported criteria for early osteoarthritis (OA) illness after anterior cruciate ligament reconstruction (ACLR).Methods. Participants completed the Knee Injury and Osteoarthritis Outcomes Score (KOOS) at a single time point 5.0-7.9 months post-ACLR. We used established KOOS subscale criteria (i.e., Luyten original and Englund original) to define patient-reported early OA illness. A two-by-two contingency table and McNemar's test were used to compare the prevalence of participants who met the Luyten original versus Englund original KOOS criteria for early OA illness. These analyses were repeated using KOOS subscale thresholds based on established population-specific patient acceptable symptom state (PASS) within the Luyten and Englund KOOS criteria (i.e., Luyten PASS and Englund PASS).Results. A greater prevalence of participants with ACLR met the Luyten original criteria (n = 165 [54%]) compared to those who met the Englund original criteria (n = 128 [42%]; χ 2 = 19.3, P < 0.001]). When using the KOOS subscale PASS as thresholds, a significantly greater prevalence of participants with ACLR met the Luyten PASS criteria (n = 133 [43%]) compared to those who met the Englund PASS criteria (n = 85 [28%]; χ 2 = 48.0, P < 0.001). When combining the Luyten and Englund KOOS criteria and using the original/PASS subscale thresholds, respectively, 40%/57% of participants met neither, 24%/15% met only 1, and 36%/28% met both KOOS criteria.Conclusion. Regardless of the classification criteria used to define early OA illness, it is concerning that 28-54% of patients report considerable symptoms ~6 months post-ACLR. Our findings will improve the classification criteria to define early OA illness, which may raise awareness for the need of population-specific criteria.symptom state [PASS] question) 1 and 2 years post-ACLR (mean AE SD age 29.7 AE 11.5 years) (7). Being able to reliably identify

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“…Contrary to the evidence linking quadriceps strength after ACLR and outcomes, only limited and contradictory knowledge is available regarding the changes in hamstring muscle function after ST tendon harvest. 3,12,17 Countering external tibial rotation and knee valgus moments, the ST is an established dynamic stabilizer of the knee. 1,16,26 The reduction in ST muscle activity with the corresponding increases in BF muscle activity might induce an essential rotational instability in the knee joint, as ST tendon harvest might even promote external rotation of the tibia due to higher lateral hamstring muscle recruitment while reducing muscle control of internal rotation.…”

Section: Discussionmentioning

confidence: 99%

Biceps Femoris Compensates for Semitendinosus After Anterior Cruciate Ligament Reconstruction With a Hamstring Autograft: A Muscle Functional Magnetic Resonance Imaging Study in Male Soccer Players

et al. 2021

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Background: Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent. This study intended to investigate the repercussions of ST harvest for ACLR on hamstring muscle function. Hypothesis: Harvest of the ST tendon for ACLR was expected to have a significant influence on hamstring muscle activation patterns during eccentric exercises, evaluated at RTP in a population of male soccer athletes. Study Design: Controlled laboratory study. Methods: A total of 30 male soccer players with a history of ACLR who were cleared for RTP and 30 healthy controls were allocated to this study during the 2018-2019 soccer season. The influence of ACLR on hamstring muscle activation patterns was assessed by comparing the change in T2 relaxation times [ΔT2 (%) = [Formula: see text]] of the hamstring muscle tissue before and after an eccentric hamstring loading task between athletes with and without a recent history of ACLR through use of muscle functional magnetic resonance imaging, induced by an eccentric hamstring loading task between scans. Results: Significantly higher exercise-related activity was observed in the biceps femoris (BF) of athletes after ACLR compared with uninjured control athletes (13.92% vs 8.48%; P = .003), whereas the ST had significantly lower activity (19.97% vs 25.32%; P = .049). Significant differences were also established in a within-group comparison of the operated versus the contralateral leg in the ACLR group (operated vs nonoperated leg: 14.54% vs 11.63% for BF [ P = .000], 17.31% vs 22.37% for ST [ P = .000], and 15.64% vs 13.54% for semimembranosus [SM] [ P = .014]). Neither the muscle activity of SM and gracilis muscles nor total posterior thigh muscle activity (sum of exercise-related ΔT2 of the BF, ST, and SM muscles) presented any differences in individuals who had undergone ACLR with an ST tendon autograft compared with healthy controls. Conclusion: These findings indicate that ACLR with a ST tendon autograft might notably influence the function of the hamstring muscles and, in particular, their hierarchic dimensions under fatiguing loading circumstances, with increases in relative BF activity contribution and decreases in relative ST activity after ACLR. This between-group difference in hamstring muscle activation pattern suggests that the BF partly compensates for deficient ST function in eccentric loading. These alterations might have implications for athletic performance and injury risk and should probably be considered in rehabilitation and hamstring injury prevention after ACLR with a ST tendon autograft.

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Association of Quadriceps Strength Symmetry and Surgical Status With Clinical Osteoarthritis Five Years After Anterior Cruciate Ligament Rupture

Cited by 33 publications

References 32 publications

Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

Return‐to‐sport quadriceps strength symmetry impacts 5‐year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis

Prevalence of Early Knee Osteoarthritis Illness Among Various Patient‐Reported Classification Criteria After Anterior Cruciate Ligament Reconstruction

Biceps Femoris Compensates for Semitendinosus After Anterior Cruciate Ligament Reconstruction With a Hamstring Autograft: A Muscle Functional Magnetic Resonance Imaging Study in Male Soccer Players

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