Preoperative muscle thickness influences muscle activation after arthroscopic knee surgery

Abstract Purpose The aim of this study was to compare the correlation between preoperative quadriceps femoris muscle thickness and postoperative neuromuscular activation and quadriceps femoris strength in patients with and without patellofemoral pain after arthroscopic partial meniscectomy. Methods A series of 120 patients were prospectively analysed in a longitudinal cohort study of patients scheduled for arthroscopic partial meniscectomy. The patellofemoral pain group included patients who developed anterior knee pain after surgery while the control group included those who had not done so. Patients with preoperative patellofemoral pain, previous knee surgeries as well as those on whom additional surgical procedures had been performed were excluded. Of the 120 initially included in the study, 90 patients were analysed after the exclusions. Results There is a direct correlation between preoperative quadriceps femoris muscle thickness and the neuromuscular activity values and the strength of the muscle at 6 weeks after surgery. These results were seen exclusively in the group of patients who do not develop patellofemoral pain (0.543, p = 0.008). The group of patients who developed anterior knee pain in the postoperative period did not show this correlation (n.s.). Conclusion In patients without patellofemoral pain after meniscectomy, the greater the preoperative thickness of the quadriceps femoris, the more postoperative neuromuscular activation and strength they had. This correlation did not occur in those patients who develop patellofemoral pain after meniscal surgery. Level of evidence II.

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Patellofemoral Pain After Arthroscopy: Muscle Atrophy Is Not Everything

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211013000 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712110130

Author(s):

Jorge Amestoy ◽

Daniel Pérez-Prieto ◽

Raúl Torres-Claramunt ◽

Juan Francisco Sánchez-Soler ◽

Joan Leal-Blanquet ◽

...

Keyword(s):

Cohort Study ◽

Muscle Strength ◽

Muscle Thickness ◽

Functional Results ◽

Quadriceps Femoris ◽

Partial Meniscectomy ◽

Control Group ◽

Arthroscopic Partial Meniscectomy ◽

Quadriceps Femoris Muscle ◽

Femoris Muscle

Background: It remains unclear as to why patellofemoral pain (PFP) appears in some patients after knee arthroscopy and what influence the quadriceps muscle has on its onset. Purpose: To compare muscle thickness, neuromuscular contractility, and quadriceps femoris muscle strength between patients who develop PFP after arthroscopic partial meniscectomy and a control group and to compare functional outcomes between these entities. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective longitudinal cohort study was carried out on patients scheduled for arthroscopic partial meniscectomy. Patients were excluded if they had preoperative PFP, previous knee surgery, or additional surgical procedures (eg, meniscal repair or microfracture). The following were performed preoperatively: magnetic resonance imaging to quantify muscle thickness, surface electromyography to analyze electrical contractility, and an isokinetic study to assess the strength of the quadriceps femoris muscle. Patients also completed a Lysholm functional questionnaire. Six weeks after the index procedure, patients were questioned about the presence of PFP, and the same tests were repeated. The PFP group included patients who developed anterior knee pain postoperatively, while the control group included those who did not develop pain. Results: Of 90 initial study patients, 20 were included in the PFP group (23.8%) and 64 in the control group (76.2%); 6 patients were lost to follow-up. Both study groups were comparable on all of the analyzed preoperative variables. Patients in the PFP group had worse results in terms of muscle thickness (9.67 vs 16.55 cm2), electrical contractility (1226.30 vs 1946.11 µV), and quadriceps strength (12.27 vs 20.02 kg; all P < .001). They also presented worse functional results on the Lysholm score (63.05 vs 74.45; P < .001). Conclusion: Patients who developed PFP after arthroscopic partial meniscectomy had more quadriceps femoris muscle atrophy as well as a greater decrease in electrical contractility and muscle strength at 6 weeks postsurgically as compared with a control group. The PFP group also had worse postoperative functional results.

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Effects of magnetic stimulation compared to electrical stimulation on muscle contraction in quadriceps femoris muscle of healthy subjects: A pilot study

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1297 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Ryosuke Nakanishi ◽

◽

Minoru Tanaka ◽

Noriaki Maeshige ◽

Hidemi Fujino ◽

...

Keyword(s):

Electrical Stimulation ◽

Muscle Contraction ◽

Healthy Subjects ◽

Magnetic Stimulation ◽

Muscle Thickness ◽

Rectus Femoris ◽

Superficial Layer ◽

Quadriceps Femoris ◽

Quadriceps Femoris Muscle ◽

Femoris Muscle

Background/Aims: This study investigated whether pulsed magnetic stimulation contracts superficial and/or deep muscles compared with those induced by electrical stimulations, i.e., low- and kilohertzfrequency currents. Methods: Eight healthy subjects were recruited and measured the quadriceps femoris muscle thickness using ultrasound imaging, and Visual Analog Scale (VAS) for stimulation-induced pain during the same stimulation intensity. Results: Pulsed magnetic stimulation increased the thickness of rectus femoris muscle similar to other electrical stimulations, but not the vastus intermedius muscle. Meanwhile, the pain score of VAS caused by pulsed magnetic stimulation was lower than that by those electrical stimulations. Conclusions: These results suggest that pulsed magnetic stimulation is effective for the contraction of superficial layer muscles without stimulation-induced pain but not for contraction of deep layer muscles. Keywords: pulsed magnetic stimulation; electrical stimulation; stimulation-induced pain; muscle contraction.

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The 45-second anterior knee pain provocation test: A quick test of knee pain and sporting function in 10–14-year-old adolescents with patellofemoral pain

Physical Therapy in Sport ◽

10.1016/j.ptsp.2021.11.002 ◽

2021 ◽

Author(s):

Michael Skovdal Rathleff ◽

Sinead Holden ◽

Kasper Krommes ◽

Lukasz Winiarski ◽

Per Hölmich ◽

...

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Provocation Test ◽

Patellofemoral Pain ◽

Quick Test ◽

Pain Provocation Test ◽

Pain Provocation ◽

Anterior Knee

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Patellofemoral Pain, Chondrosis, and Arthritis: A 18-Year-Old with Anterior Knee Pain and Normal Articular Cartilage

10.1007/978-3-030-81545-5_15 ◽

2021 ◽

pp. 157-160

Author(s):

Sheanna Maine ◽

Stacey Compton ◽

Ebenezer Francis Arthur

Keyword(s):

Articular Cartilage ◽

Knee Pain ◽

Anterior Knee Pain ◽

Patellofemoral Pain ◽

Anterior Knee

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Experimental anterior knee pain replicates aspects of muscle dysfunction in patellofemoral pain

Journal of Science and Medicine in Sport ◽

10.1016/s1440-2440(03)80216-5 ◽

2003 ◽

Vol 6 (4) ◽

pp. 96

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Patellofemoral Pain ◽

Muscle Dysfunction ◽

Anterior Knee

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Rasch analysis of the anterior knee pain scale in adolescents with patellofemoral pain

Clinical Rehabilitation ◽

10.1177/0269215520942950 ◽

2020 ◽

Vol 34 (12) ◽

pp. 1512-1519

Author(s):

Mitchell Selhorst ◽

Alicia Fernandez-Fernandez ◽

M Samuel Cheng

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Rasch Analysis ◽

Principal Component ◽

Pain Scale ◽

Patellofemoral Pain ◽

Level Measurement ◽

Level Data ◽

Item Responses ◽

Anterior Knee

Objective: The aim of this study was to evaluate the Anterior Knee Pain Scale in a cohort of adolescents being treated conservatively for patellofemoral pain using Rasch analysis. Design: This is a psychometric study. Setting: Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States) Subjects: A total of 646 adolescent patients with patellofemoral pain (76% female, 14.6 ± 1.6 years old). Intervention: Not applicable. Main Measure: The Anterior Knee Pain Scale. Results: The median Anterior Knee Pain Scale score was 73 (interquartile range 64–81), with scores ranging from 7 to 100 on the 100-point scale. The Rasch person reliability for the Anterior Knee Pain Scale was 0.74 and the Cronbach’s alpha was 0.75, representing an acceptable person reliability. Principal component analysis revealed a ratio of 5.2:1 demonstrating acceptable unidimensionality of the Anterior Knee Pain Scale. A significant misfit was observed in the item “Abnormal Painful Kneecap Movements” (Outfit Means Square 2.74, Infit Means Square 1.41). Ordering of item responses was unsatisfactory as only five of the 13 items demonstrated appropriate distinction between each of the responses. There was no differential item functioning for sex or age for all items of the Anterior Knee Pain Scale, based upon the criterion of ⩾ 0.5 logit difference. Conclusion: The Anterior Knee Pain Scale does not meet interval-level measurement criteria and should be considered ordinal level data.

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Arthroscopic Lateral Retinacular Ligament Release in Patellofemoral Pain Syndrome

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00187 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0018

Author(s):

Teoman Başaran ◽

Ahmet Ozgur Atay ◽

Mahmut Nedim Doral ◽

Pınar Özge Başaran

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Bleeding Time ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Lateral Release ◽

Lateral Retinacular Release ◽

Anterior Knee ◽

Surgery Duration

Objectives: Arthroscopic lateral retinacular release in patellofemoral pain syndrome Comparing the amount of hemorrhage and times of release between electrocautery and a new techniques for arthroscopic lateral release with scissors Methods: 77 patients included in this prospective randomized controlled study. Inclusion Criteria: 1. Over the age of fourteen and have anterior knee pain syndrome 2. Tightness in lateral part of knee 3. Despite receiving conservative treatment for 6 months, patients who have anterior knee pain complaints Exclusion Criteria: 1. Diseases that prolong bleeding time 2. Drugs that prolong bleeding time 3. Abnormal APTT-INR levels 4. Patients underwent anterior cruciate reconstruction surgery 5. Patients underwent microfracture surgery 6. Patients underwent meniscus repair surgery 7. Patients underwent synovectomy -- Due to inflammatory diseases and synovial chondromatosis is excluded from the study. In this study 77 (25M 52W med age 50,14 ± 14,17 ) patients divided into three groups which was similar in age and sex. All patients underwent standard arthroscopic surgery for patellofemoral knee sydrome and meniscal debridement 1. Group 1 (Control) (n:10) LRL was preserved 2. Group 2 (Scissors) (n:33) LRL was released with Scissors 3. Group 3 (Electrocautery) (n:34) LRL was released with Electrocautery Results: There was no difference between the groups in terms of socio-demographic characteristics. All lateral ligaments releases were performed under tourniquet . The release is not considered to be complete unless the patella can be stood on its medial edge without difficulty . In all patients, surgery duration was recorded. To calculate the amount of bleeding the blood in the drainage tube was recorded for 24 hours after surgery. For 67 patients based on clinical examination at surgery and in the immediate postoperative period, all releases were felt to be adequate. For all groups total bleeding at 24 h postoperatively is the statistically same (p:0.850) . In first 8 hours the amount of bleeding is more in scissors group (p:0.002). Lateral release time is longer in electrocautery group (380 seconds) than in scissors group (24 seconds). In release with electrocautery sometimes we used additional techniques scissors and scalpel for enough release. There was no difference between groups in terms of complications such as deep vein thrombosis , hemarthrosis or severe complications. Conclusion: In this study the amount of bleeding was the same in the groups but surgery duration was longer in electrocautery group. Our new technique for intraarticular arthroscopy guided lateral retinacular release uses with scissors which is simple, effective, rapid, and have resulted a few surgical complications such as superficial skin infection which responds oral antibiotics. Electrocautery is difficult and needs experience.

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Limb Position Biofeedback for Patellofemoral Pain

Biofeedback ◽

10.5298/1081-5937-37.3.112 ◽

2009 ◽

Vol 37 (3) ◽

pp. 112-113

Author(s):

Wong Yiu Ming

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Patellofemoral Pain ◽

Patellar Tracking ◽

Knee Valgus ◽

Functional Movement ◽

Limb Position ◽

Biofeedback System ◽

Hip Rotation ◽

Anterior Knee

Abstract Individuals with excessive internal hip rotation and knee valgus during functional movement often develop abnormal lateral patellar tracking, sometimes resulting in anterior knee pain. A configuration of currently available biofeedback instruments, including an electronic goniometer, can provide feedback on limb position, which is useful in correcting the knee valgus. The article reports on the use of this biofeedback system with three individuals with measurable knee valgus, producing a remediation of the limb angle in each case.

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