Abstract
PurposeThe 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.MethodsA 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.ResultsThere 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.).ConclusionIn 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 evidenceII.
Highlights
Quadriceps activation failure (QAF) occurs due to altera‐ tions in neural signalling caused by a reduction in alpha motor neuron pool recruitment and/or firing rate [12]
This has been attributed to arthrogenic muscle inhibition, [21] a process in which quadriceps activation failure is caused by neural inhibition [30]
The aim of this study was to compare the correlation between preoperative quadriceps muscle thickness, its post‐ operative neuromuscular activation and strength in patients with and without patellofemoral pain after arthroscopic par‐ tial meniscectomy (APM)
Summary
Quadriceps activation failure (QAF) occurs due to altera‐ tions in neural signalling caused by a reduction in alpha motor neuron pool recruitment and/or firing rate [12]. It commonly occurs after knee surgery and is not an isolated local phenomenon related to atrophy. Activation failure is the inability to completely volition‐ ally contract the muscle due to alterations in neural signal‐ ling. It is common following any type of knee surgery [12, 14]. QAF can significantly impede strength gains by only allowing portions of the muscles to be voli‐ tionally utilized during active exercise [13, 19]
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