Preoperative muscle thickness influences muscle activation after arthroscopic knee surgery

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.

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

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.

Comparison of Hamstrings and Quadriceps Femoris Muscle Thickness Increment between Agonist-Antagonist Paired Set and Traditional Set Resistance Training in Untrained Healthy Subjects

Background: Resistance training is an effective way to increase muscle mass. Resistance training with agonist-antagonist paired set method can be an alternative to increase muscle mass within a relatively short training time.Aim: To compare the increase in hamstrings and quadriceps femoris muscle thickness between agonist-antagonist paired set (APS) and traditional set (TS) resistance training in untrained healthy subjects.Material and Methods: This study was an experimental study on 16 untrained healthy men which were randomly assigned to the APS and the TS group. Each group got leg curl and leg extension exercises with equal training volume for 6 weeks. For the APS group, 1 set of leg curls was followed by 1 set of leg extensions, repeated for 3 sets. For the TS group, 3 sets of leg curls were followed by 3 sets of leg extensions. Muscle thickness was compared from pre- to post-training and between the intervention groups using B-mode ultrasound.Results: Muscle thickness of the hamstrings and quadriceps femoris increased significantly from pre- to post-training in both groups (p<0.05). The increase in muscle thickness between the two groups was not significantly different (p> 0.05).Conclusion: Resistance training with the APS method did not give a higher increment of hamstrings and quadriceps femoris muscle thickness compared to the TS method in healthy untrained subjects.

Relationship between modified Nutrition Risk in the Critically Ill (mNUTRIC) Score and nutrition intake with quadriceps femoris muscle thickness in critically ill patients

Muscle wasting in critical illness is seen from inadequate nutrition intake and stress catabolism. Modified Nutrition Risk in the Critically Ill (NUTRIC) Score is a screening tool that measures starvation, inflammation, disease severity, and organ dysfunction. Relationship between muscle strength and muscle thickness causes the evaluation of muscle thickness is quite relevant. This study aimed to analyze the relationship between modified NUTRIC score and nutrition with muscle wasting in critically ill patients. The study was conducted on 30 patients in the ICU Dr Soetomo Hospital Surabaya. Nutritional intake and thickness of the quadriceps femoris muscle were monitored for one week. There was a relationship between mNUTRIC score with quadriceps femoris muscle thickness on days 3rd, 5th, and 7th. In the comparison between the low risk group and the high-risk group, it was found that there was a significant difference in the change in the percentage of muscle thickness difference on the 3rd, 5th and 7th day observation. There is a relationship between protein debt with quadriceps femoris muscle thickness (p = 0.008) with a positive correlation with moderate correlation strength (r = 0.477) on day 7. In conclusion, the modified NUTRIC Score had a moderate relationship with quadriceps femoris muscle thickness in critical patients from day 3rd until day 7th. The calorie intake not had a relationship with quadriceps femoris muscle thickness. Protein intake had a moderate relationship with quadriceps femoris muscle thickness only on day 7th measurement in critical patients. Keywords : Modified NUTRIC Score, Nutrition, Quadriceps Femoris muscleCorrespondence : [email protected]

Patellofemoral Pain After Arthroscopy: Muscle Atrophy Is Not Everything

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.