Muscle strength, functional performance, and self‐reported outcomes four years after arthroscopic partial meniscectomy in middle‐aged patients

Ericsson, Ylva; Roos, Ewa M.; Dahlberg, Leif

doi:10.1002/art.22346

Cited by 93 publications

(113 citation statements)

References 92 publications

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“…The asymmetry in concentric strength measured in this study (15%) fits well with the deficits previously reported in similar populations at different postoperative times (29% after 1 month, 20% after 3 months, 6%-9% after 1-4 years) [12,15]. We also observed a significant isometric strength asymmetry (12%), whereas eccentric peak torque asymmetry (6%) did not reach significance.…”

Section: Discussionsupporting

confidence: 91%

“…Concentric peak torque was found to be significantly lower on the involved than on the uninvolved quadriceps (ie, side-to-side asymmetry) at 1 (30%), 3 (18%), and even 6 months (13%) postsurgery. Such asymmetry in quadriceps strength could be significant even years after meniscectomy [12]. This is an important message because muscle function recovery from Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

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Neuromuscular Function after Arthroscopic Partial Meniscectomy

Glatthorn

Berendts

Bizzini

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Quadriceps muscle strength, which is essential for the function and stability of the knee, has been found to be impaired even years after arthroscopic partial meniscectomy. However, the neuromuscular alterations that could account for such muscle weakness remain unclear. Questions/purposes We investigated (1) the side-to-side asymmetries in quadriceps muscle strength 6 months after arthroscopic partial meniscectomy, (2) the physiologic mechanisms (neural versus muscular) underlying muscle weakness, and (3) the impact of quadriceps weakness on muscle control at submaximal force levels. Patients and Methods We tested 14 volunteers (10 men, four women) with an average age of 44 ± 9 years (range, 24-59 years) at 6 ± 1 months after unilateral medial arthroscopic partial meniscectomy. We measured maximal voluntary strength and muscle activation during isometric, concentric, and eccentric contractions using isokinetic dynamometry and surface EMG, respectively. We assessed vastus lateralis muscle size and architecture using ultrasonography. We measured muscle control at submaximal force levels with a repositioning test (knee proprioception) and a low-force target-tracking task (steadiness, accuracy). Results Isometric and concentric quadriceps strength and vastus lateralis EMG activity were lower on the involved than on the uninvolved side. Muscle architecture and muscle control did not differ between the involved and uninvolved sides. Conclusions Our results showed quadriceps weakness exists 6 months after arthroscopic partial meniscectomy. As suggested by the EMG results, this is likely attributable to neural impairments (activation failure) that affect muscle control at maximal but not submaximal force outputs.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Neuromuscular Function after Arthroscopic Partial Meniscectomy

Glatthorn

Berendts

Bizzini

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…The upper limbs as a swinging element, could therefore be one of the strongest influencing factors is the knee strength assessments. Interestingly, in a literature review 7 of 18 studies (39%) [6,15,19,21,22,23,24] relating to the hop test do not describe the use of the arms. Additionally, the method of measuring the distance of the hop differed considerably.…”

Section: Philipp Weng Et Al Validity Of Two Clinical Knee Strength Amentioning

confidence: 99%

“…However, this type of test also reflects neuromuscular control, power, joint function, and range of motion, as well as the self-esteem and confidence of the participants [15]. Further studies as Pincivero et al [9], Petsching et al [18], English et al [7] and Ericsson et al [19] only assessed the single leg hop test for distance compared to an isokinetic dynamometer. No previous study describes the relationships between a single legged hop test, hand held dynamometer (HHD) and an isokinetic dynamometer test.…”

Section: Introductionmentioning

confidence: 99%

Validity of Two Clinical Knee Strength Assessments Compared to the Reference Standard

Weng¹,

Janssen²,

Richards³

et al. 2015

IJPR

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Objectives: Patello femoral Pain (PFP) is the most common lower limb condition encountered in clinical practice. It recently emerged as the third highest ranked topic out of 185 in the Chartered Society of Physiotherapy Musculoskeletal Research Priority Project. For a valid assessment of knee strength during rehabilitation, the isometric test using the isokinetic dynamometer (Cybex) and the hand-held dynamometer (HHD) is not well received with clinical practice. An alternative way is through functional hop tests which clinicians have used to assess their patients' lower extremity muscular strength. This study investigates the validity of knee strength assessments conducted with the HHD and the hoptest compared to the isokinetic dynamometer and also explores differences between genders of the three assessments.Design: Each assessment included one submaximal and three recorded maximal efforts of the dominant leg. Quadriceps muscle strength was displayed in normalized torques. Correlation coefficients and box-and-whisker plots was used to analyze the data. Setting: Movement analysis laboratoryParticipants: Sixteen males (age 23.5 ± 4.23 years, height 1.79 ± 0.08 m and body mass 76.21 ± 10.58 kg, BMI 23.82 ± 2.38 kg/m²) and 16 females (age 25.38 ± 5.49 years, height 1.67 ± 0.08 m and body mass 71.99 ± 16.05 kg, BMI 25.83 ± 4.74 kg/m²) between 18 and 40 years old without any musculoskeletal injuries participated. Main outcome measures:Knee moments normalized for bodyweight (Nm/kg) for dynamometers and distance jumped for single legged hoptest. Results:The strongest significant correlation was found for the comparison between the HHD and Cybex (r=0.71, r²=0.504, p=0.001). Correlation between the HHD and hoptest (r=0. 4, r²=0.19, p=0.013), and Cybex and hoptest (r=0.53, r²=0.295, p=0.001) were poor. Comparing genders, the normalized knee extension moment on the Cybex was 28.8% lower and with the HHD 22.3% lower for females. Conclusions:Single legged hop test appears not to provide a suitable alternative for strength measurement in a clinical setting. Differences in hop performances, especially the use of the arms, seem to be important. Gender differences exist in knee strength assessments. The use of EMG-Analysis in further research might identify differences in muscle recruiting during all three tests.

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“…2,5,6,9 It has been reported that hamstrings strength resolves quickly after APM, yet quadriceps strength is markedly decreased immediately after APM, and weakness may persist long after the injury. 2,3,[9][10][11][12][13][14][15][16] APM patients often return to sport and activities of daily living weeks after surgery even in the presence of these neuromuscular quadriceps deficits. 17 The quadriceps play a critical role in joint stability and dynamic function at the knee, including force attenuation and resisting knee-adduction moments during the stance phase in walking gait.…”

mentioning

confidence: 99%

Effects of Arthroscopic Partial Meniscectomy on Quadriceps Strength: A Systematic Review

McLeod¹,

Gribble²,

Pfile³

et al. 2012

Journal of Sport Rehabilitation

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Context: Arthroscopic partial meniscectomy (APM) after meniscal tear has been widely accepted and associated with quick return to activity. Unfortunately, meniscectomy is associated with risk for knee osteoarthritis, which may be attributed to postsurgical quadriceps weakness. This has important implications, as the quadriceps play a prominent role in knee stabilization and energy attenuation in the lower extremity. Objective: To determine the magnitude of interlimb quadriceps strength deficits in people with unilateral APM by systematically reviewing the current literature. Evidence Acquisition: The Web of Knowledge databases were searched on September 22, 2010, using terms meniscus OR meniscectomy AND quadriceps strength OR quadriceps weakness. Included articles were written in English, reporting means and SDs of isokinetic peak torque at 60° and 180°/s for both limbs. Evidence Synthesis: Four articles were included in the final analysis. Effect sizes and 95% confidence intervals (CI) were calculated between limbs for periods less than 1 mo, 1-3 mo, 3-6 mo, and more than 6 mo. Conclusion: Homogeneous effect sizes indicate quadriceps weakness in the involved limb. Effects were strong at less than 1 mo (d = -1.01 to -1.62), while weak to strong effects were found for 1-3 mo (d = -0.40 to -8.04) and 3-6 mo (d = -0.40 to -5.11). Weak effects were found at more than 6 mo (d = -0.30 to -0.37). Definitive effects with a CI not crossing zero were found in 65% of the data. Although APM patients return to function within weeks after surgery, prolonged quadriceps strength deficits may increase the risk of knee-joint degeneration. Furthermore, evidence of bilateral dysfunction after unilateral injury may suggest that neuromuscular deficits post-APM are greater than the interlimb differences found in this review. Further research should be conducted to determine the nature of strength deficits and the best methods for restoring strength after APM.

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Muscle strength, functional performance, and self‐reported outcomes four years after arthroscopic partial meniscectomy in middle‐aged patients

Cited by 93 publications

References 92 publications

Neuromuscular Function after Arthroscopic Partial Meniscectomy

Neuromuscular Function after Arthroscopic Partial Meniscectomy

Validity of Two Clinical Knee Strength Assessments Compared to the Reference Standard

Effects of Arthroscopic Partial Meniscectomy on Quadriceps Strength: A Systematic Review

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