Relationship between isokinetic strength and tibiofemoral joint space width changes following ACL reconstruction

Tourville, Timothy W.; Jarrell, Kathleen M.; Naud, Shelly; Johnson, Robert J.; Beynnon, Bruce D.

doi:10.1016/j.joca.2013.02.486

Cited by 2 publications

(10 citation statements)

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“…The use of NMES over a longer time interval after surgery, or more frequent daily/weekly use, may better maintain muscle size and strength and limit limb asymmetries when patients begin to return to sports and preinjury activity levels, in turn possibly protecting against future joint abnormalities. 31…”

Section: Discussionmentioning

confidence: 99%

“…Isometric (70°) and isokinetic (60 and 180 deg/s) peak torque about the knee were evaluated using a HUMAC NORM 770 dynamometer (CSMi Solutions), as described previously 31 and in detail in the Appendix (available online).…”

Section: Methodsmentioning

confidence: 99%

“…Single-leg hop tests were conducted, as previously described 31 and detailed in the Appendix (available online). Patient-reported assessments of their knee were performed using the Knee injury and Osteoarthritis Outcome Score 28 and International Knee Documentation Committee (IKDC) 2000 subjective form.…”

Section: Methodsmentioning

confidence: 99%

“…Anterior cruciate ligament (ACL) injuries and reconstruction (ACLR) promote muscle weakness that can persist for years despite rehabilitation. 25,31 Persistent muscle weakness contributes to dissatisfaction with ACLR 16 and may hasten the progression of osteoarthritis, 31 suggesting the need for improvements in current rehabilitation programs.…”

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confidence: 99%

“…hasten the progression of osteoarthritis, 31 suggesting the need for improvements in current rehabilitation programs.…”

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confidence: 99%

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Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

et al. 2020

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Background: Anterior cruciate ligament (ACL) injuries and reconstruction (ACLR) promote quadriceps muscle atrophy and weakness that can persist for years, suggesting the need for more effective rehabilitation programs. Whether neuromuscular electrical stimulation (NMES) can be used to prevent maladaptations in skeletal muscle size and function is unclear. Purpose: To examine whether early NMES use, started soon after an injury and maintained through 3 weeks after surgery, can preserve quadriceps muscle size and contractile function at the cellular (ie, fiber) level in the injured versus noninjured leg of patients undergoing ACLR. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients (n = 25; 12 men/13 women) with an acute, first-time ACL rupture were randomized to NMES (5 d/wk) or sham (simulated microcurrent electrical nerve stimulation; 5 d/wk) treatment to the quadriceps muscles of their injured leg. Bilateral biopsies of the vastus lateralis were performed 3 weeks after surgery to measure skeletal muscle fiber size and contractility. Quadriceps muscle size and strength were assessed 6 months after surgery. Results: A total of 21 patients (9 men/12 women) completed the trial. ACLR reduced single muscle fiber size and contractility across all fiber types ( P < .01 to P < .001) in the injured compared with noninjured leg 3 weeks after surgery. NMES reduced muscle fiber atrophy ( P < .01) through effects on fast-twitch myosin heavy chain (MHC) II fibers ( P < .01 to P < .001). NMES preserved contractility in slow-twitch MHC I fibers ( P < .01 to P < .001), increasing maximal contractile velocity ( P < .01) and preserving power output ( P < .01), but not in MHC II fibers. Differences in whole muscle strength between groups were not discerned 6 months after surgery. Conclusion: Early NMES use reduced skeletal muscle fiber atrophy in MHC II fibers and preserved contractility in MHC I fibers. These results provide seminal, cellular-level data demonstrating the utility of the early use of NMES to beneficially modify skeletal muscle maladaptations to ACLR. Clinical Relevance: Our results provide the first comprehensive, cellular-level evidence to show that the early use of NMES mitigates early skeletal muscle maladaptations to ACLR. Registration: NCT02945553 (ClinicalTrials.gov identifier)

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

“…hasten the progression of osteoarthritis, 31 suggesting the need for improvements in current rehabilitation programs.…”

mentioning

confidence: 99%

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Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

et al. 2020

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Skeletal muscle cellular contractile dysfunction after anterior cruciate ligament reconstruction contributes to quadriceps weakness at 6‐month follow‐up

Tourville

Voigt

Choquette

et al. 2021

Journal Orthopaedic Research

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Muscle dysfunction following anterior cruciate ligament reconstruction (ACLR) may evolve from alterations in muscle contractility at the myofilament protein level. Using a prospective, within‐subject case–control design, we evaluated cellular‐level contractility, cross‐sectional area (CSA), and myosin heavy chain (MHC) isoform expression on single muscle fibers 3 weeks post ACLR, and evaluated their relationship to whole muscle strength and patient‐oriented outcomes 6 months post operation. Biopsies of the vastus lateralis were performed 3 weeks post ACLR in 11 subjects (5 females, mean age ± SD = 24.7 ± 6.5 years, height = 172.7 ± 8.2 cm, mass = 75.7 ± 12.5 kg) following first‐time ACL rupture and whole muscle strength and self‐reported pain, function, and quality of life assessed 6 months post ACLR. At 3 weeks post ACLR, force production was reduced (p < 0.01) in MHC I (−36%) and IIA (−48%) fibers compared with the non‐injured leg. When force production was expressed relative to CSA to account for fiber atrophy, reductions remained in MHC IIA fibers (−40%; p < 0.001), but MHC I fibers showed only a trend toward being lower (−13%; p = 0.09). Finally, skeletal muscle fiber functional deficits at 3 weeks post ACLR were associated with whole muscle weakness and less favorable patient‐reported outcomes at 6‐month follow‐up. Thus, ACLR promotes early cellular contractile dysfunction that may contribute to decreased whole muscle strength and patient function, and increased patient‐reported symptoms, at 6‐month follow‐up.

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Relationship between isokinetic strength and tibiofemoral joint space width changes following ACL reconstruction

Cited by 2 publications

References 0 publications

Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

Skeletal muscle cellular contractile dysfunction after anterior cruciate ligament reconstruction contributes to quadriceps weakness at 6‐month follow‐up

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