Effect of Subcutaneous Tissue on Changes in Thigh Circumference Following Anterior Cruciate Ligament Reconstruction

Abstract

Circumference measurements have been used to estimate muscle cross-sectional area (CSA) in clinical settings. Measurements of thigh circumference are affected by muscle and subcutaneous fat (SF). In fact, SF could increase over a short period. Therefore, clarifying the relationship between thigh circumference and muscle and SF following ACL reconstruction is important. This study’s primary purpose was to examine pre- and post-operative changes in thigh circumference, thigh muscles and SF CSAs in both legs. Secondary, the relationship between thigh circumference and muscle and SF CSAs was examined to demonstrate that circumference measurements could be used to detect atrophy. Quadriceps, hamstrings, and SF CSAs at 15, 10, and 5 cm proximal to the patella were measured by MRI pre- and 4 weeks postoperatively to examine how reconstruction affected those tissues in the thighs. The results showed increases in SF CSA (r=0.72 at 10 cm, r=0.67 at 15 cm) greatly affected thigh circumference in females on the surgical side. In males, increases in SF CSA (r=0.83) at 15- and 5-cm and decreases in quadriceps muscle CSA (r=0.73) at 5 cm affected thigh circumference on the surgical side. Thigh circumference measurements might not reflect actual muscle CSA in ACL patients.

Risk Factors Associated with Cartilage Defects after Anterior Cruciate Ligament Rupture in Military Draftees

“…In a study by Otzel et al [ 32 ], 24 ACLR participants were recruited from a university campus, and no significant difference was found in thigh circumference between legs; however, strength deficits were found in the ACLR limb compared to the uninvolved leg. A previous study reported that the thigh circumference of the ACLR limb underestimated thigh atrophy and quadricep weakness persistence, averaging 48 months post-surgery [ 31 ].…”

“…The sequelae of graft failure, especially OA, are still clinically challenging problems [ 3 , 23 , 24 , 25 , 26 ]. However, the cause of OA is multifactorial and long-term outcomes after ACL injury and post-ACLR are influenced by many associated factors, such as the status of the articular cartilage, meniscus, BMI, state of the quadriceps muscles, and knee joint laxity [ 5 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Can thigh circumference predict thigh muscle volume? -Analysis using deep learning-

“…Previous research by Wade et al and Housh et al reported a strong correlation between thigh circumference and thigh muscle CSA at the mid-thigh [5,6]. On the other hand, Yoshii et al showed a significant correlation between thigh circumference and quadriceps CSA (r=0.73) at the 5 cm level, which was not significant at the 5 and 15 cm level (r=0.31, and 0.42, respectively) [7], indicating the importance of the measurement level in predicting the muscle volume. In this study, the CSAs of the vastus medialis, vastus lateral & vastus intermedius, and all muscles revealed a strong correlation with thigh circumference at 10 cm above the patella (r>0.68), supporting the clinical routine performed at hospitals.…”