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Open AccessArticle

Quadriceps Neuromuscular Impairments after Arthroscopic Knee Surgery: Comparison between Procedures

1
Human Performance Lab, Schulthess Clinic, 8008 Zurich, Switzerland
2
Laboratory of Exercise and Health, ETH Zurich, 8603 Schwerzenbach, Switzerland
3
Department of Orthopaedic Surgery, Schulthess Clinic, 8008 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1881; https://doi.org/10.3390/jcm8111881
Received: 24 September 2019 / Revised: 18 October 2019 / Accepted: 4 November 2019 / Published: 5 November 2019
(This article belongs to the Section Orthopedics)
Quadriceps neuromuscular function remains impaired in the short- and long-term following knee arthroscopy for meniscal surgery and/or anterior cruciate ligament (ACL) reconstruction. The aim of this study was to compare quadriceps neuromuscular impairments in patients following meniscal surgery with and without ACL reconstruction. Thirty patients were tested six months after meniscal surgery with (n = 15) and without (n = 15) ACL reconstruction. We bilaterally assessed knee extension maximal voluntary contraction (MVC) torque using dynamometry, vastus lateralis thickness using ultrasound, quadriceps voluntary activation and evoked knee extension torque with transcutaneous electrical stimulation. Patient-reported outcomes were evaluated with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Compared with meniscus patients, ACL patients demonstrated larger asymmetries in MVC torque (15% vs. 5%, p = 0.049) and vastus lateralis thickness (6% vs. 0%, p = 0.021). In ACL patients, asymmetries in MVC torque correlated with asymmetries in evoked torque (r = 0.622, p = 0.013). In meniscus patients, asymmetries in muscle activation correlated with KOOS quality of life (r = 0.619, p = 0.018). Patients demonstrated persistent quadriceps muscle weakness six months after ACL reconstruction, but not after isolated meniscal surgery. Quantitative and/or qualitative muscular changes likely underlie quadriceps muscle weakness in ACL patients, whereas activation failure is associated with poor quality of life in some meniscus patients.
Keywords: knee arthroscopic surgery; anterior cruciate ligament; meniscus; quadriceps; muscle; strength; atrophy; activation knee arthroscopic surgery; anterior cruciate ligament; meniscus; quadriceps; muscle; strength; atrophy; activation
MDPI and ACS Style

Casartelli, N.C.; Item-Glatthorn, J.F.; Friesenbichler, B.; Bizzini, M.; Salzmann, G.M.; Maffiuletti, N.A. Quadriceps Neuromuscular Impairments after Arthroscopic Knee Surgery: Comparison between Procedures. J. Clin. Med. 2019, 8, 1881.

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