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.

Quadriceps femoris cross-sectional area and specific leg strength: relationship between different muscles and squat variations

Background The aim was to determine the relationship between the cross-sectional area of the quadriceps femoris and strength performance in the deep and parallel barbell squat. Methods The sample included 16 university students (seven female, 24.1 ± 1.7 years). Muscle strength was expressed as external load, including the one-repetition maximum and the body mass segments involved (calculated according to Dempster’s method). The cross-sectional area of the quadriceps femoris muscles was determined using ultrasound, while leg muscle mass was measured using the Bioelectrical Impedance method. Results The cross-sectional areas of the three vastii muscles and leg muscle mass showed moderate to strong correlation with external load in both squat types (r = 0.509–0.873). However, partial correlation (cross-sectional area of quadriceps femoris muscles were controlled) showed significant association only between leg muscle mass and deep squat (r = 0.64, p < 0.05). The cross-sectional area of the vastus lateralis showed a slightly higher correlation with external load in the parallel than in the deep squat (r = 0.67, p < 0.01 vs. r = 0.59, p < 0.05). The regression analysis extracted the vastus medialis cross-sectional area as the most important factor in manifesting strength (parallel squat: R2 = 0.569; deep squat: R2 = 0.499, both p < 0.01). The obtained results suggest that parallel squat strength depends mainly on the cross-sectional area of the vastii muscles, while it seems that the performance in the deep squat requires an additional engagement of the hip and back extensor muscle groups.

HUBUNGAN Q-ANGLE DENGAN KESEIMBANGAN DINAMIS PADA LANJUT USIA DENGAN DIAGNOSIS OSTEOARTRITIS LUTUT DI PUSKESMAS TEGALLALANG I

Latar Belakang: Osteoartritis lutut merupakan proses degeneratif pada lanjut usia 60 tahun ke atas. Keluhan utama adalah nyeri lutut, kekakuan, keterbatasan gerak sendi, penurunan fleksibilitas dan kekuatan otot, hingga menyebabkan abnormalitas alignmen lutut. Terjadinya abnormalitas alignmen menyebabkan distribusi tekanan yang lebih tinggi pada sendi sehingga akan mengakibatkan ketidakstabilan pada patella akibatnya terjadi kelemahan pada otot quadriceps femoris yang mengakibatkan terjadi penurunan kemampuan mempertahankan keseimbangan dinamis. Tujuan: Tujuan penelitian ini untuk mengetahui hubungan antara Q-angle dengan keseimbangan dinamis pada lanjut usia dengan diagnosis osteoartritis lutut di Puskesmas Tegallalang I. Metode: Penelitian ini menggunakan metode studi potong lintang yang dilakukan pada 15 Maret sampai 9 April 2021 dengan populasi lanjut usia yang di diagnosis osteoartritis lutut yang telah memenuhi kriteria inklusi dan kriteria eksklusi. Responden dipilih dengan menggunakan teknik non probability sampling dengan bentuk purposive sampling, berdasarkan rumus besar sampel didapatkan 38 responden. Pengukuran Q-angle dengan menggunakan goniometer dan keseimbangan dinamis menggunakan time up and go test. Hasil: Hasil penelitian menunjukan analisis hubungan antara Q-angle dengan keseimbangan dinamis pada lanjut usia dengan diagnosis osteoartritis lutut dengan uji pearson dengan hasil p sebesar 0,003 (p<0,05) dengan nilai koefisien korelasi sebesar 0,476 (r>0,05) yang menunjukkan hubungan yang kuat. Simpulan: Terdapat hubungan antara Q-angle dengan keseimbangan dinamis pada lanjut usia dengan diagnosis osteoartritis lutut.

Sub-elite sprinters and rugby players possess different morphological characteristics of the individual hamstrings and quadriceps muscles

Numerous studies have clarified that sprinters possess unique morphological characteristics of the thigh muscles compared with non-athletes. However, little evidence is available regarding the morphological differences between sprinters and rugby players. This study aimed to examine the morphological differences in the individual hamstrings and quadriceps femoris muscles between sub-elite sprinters and rugby players. Ultrasound images were acquired from the proximal, middle, and distal regions of the thigh. From the images, the anatomical cross-sectional areas were calculated for 14 sub-elite sprinters, 14 rugby players, and 14 non-athletes. The calculated anatomical cross-sectional areas were normalized to two-thirds power of the body mass, and the normalized values of all regions were averaged as those of the individual muscles. In the hamstrings, the sizes of the biceps femoris short head and semitendinosus were greater in the sprinters than in the rugby players and/or non-athletes (all p < 0.05). In contrast, in the quadriceps femoris, the sizes of the rectus femoris, vastus lateralis, and vastus intermedius were the greatest in the rugby players (all p < 0.05). In the middle region of the biceps femoris short head and the proximal-middle regions of the semitendinosus, the muscle sizes were greater in the sprinters than in the rugby players (all p < 0.05), and vice versa in the middle-distal regions of the rectus femoris (all p < 0.05). These results suggest that 1) sub-elite sprinters possess larger sizes of the biceps femoris short head and semitendinosus, whereas rugby players have larger sizes of the rectus femoris, vastus lateralis, and vastus intermedius, and 2) each of the athletes has different size distributions, especially along the lengths of BFsh, ST, and RF. The findings of the present study would be helpful for rugby players in designing training regimens aimed at enhancing sprint performance.

Modified Judet’s Quadricepsplasty with patella traction for extension contracture of knee

To see the clinical result of Modified Judet’s Quadricepsplasty (MJQP) with patella traction at BARI-ILIZAROV ORTHOPAEDIC CENTRE for the treatment of knee extension contracture. Materials and methods: We received 16 patients with knee extension contracture treated by MJQP with patella traction from January 2015 to January 2021, at our BARI-ILIZAROV ORTHOPAEDIC CENTRE. The age at revision surgery was 25-58 years. The time between fracture treatment to MJQP was 4 to 20 months and our follow up was 10-30 months. We assessed pre-operative and post-operative range of motion (ROM). Results: Knee range of motion pre-operatively was 5-50 (35± 10)° and 35-85 (55±10)° after MJQP and in average of 0-35(18+10) °. We applied patella traction for 12-14 (10±3)° When we removed the patella traction the knee range of motion at that time was 95-110 (93±4)° and increase of 10-70 compared with the range of motion after release of all arthrofibrosis in the joint. Our follow up time was 12-35 (19±5) months. Knee range of motion at first follow up was 85-135 (105±13)°, an increase of 45-105 (70±15) ° compared with pre-operatively and of 10-45 (12±12)° compared with the range of motion after patella traction removed. Knee function was excellent in 12 cases (70%), good in 3 (27%) and fair in one (3%). Conclusion: MJQP with patella traction lengthens the contracted Quadriceps femoris gives excellent result with proper post-operative care and CPM therapy.

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.