Quadriceps inhibition following arthroscopy in patients with anterior knee pain

Abstract 

Objectives. This study was aimed at investigating muscle strength and quadriceps inhibition in patients with unilateral anterior knee pain syndrome.

Design. Functional assessments were made before an arthroscopic knee surgery and 6 weeks and 6 months following the surgical intervention.

Background. Traumatic knee injuries have been associated with severe muscle inhibition of the knee extensor muscles. Muscle inhibition is a serious hindrance in the rehabilitation process and prevents full functional recovery of the affected joint.

Methods. 30 patients participated in the study. Isometric quadriceps strength was measured using a KinCom dynamometer. Muscle inhibition was assessed using the interpolated twitch technique which requires applying a single electrical twitch to the femoral nerve during a maximal isometric knee extensor contraction. Pain was assessed with a 100 mm visual analogue pain scale.

Results. Pre-surgery, substantial muscle inhibition and pain was observed in the affected leg compared with the contralateral leg. Over the 6 month period there was a decrease in pain and muscle inhibition, although the decrease in muscle inhibition failed to reach statistical significance. Muscle strength showed a decrease 6 weeks post-surgery followed by an increase 6 months following surgery compared with pre-surgical values.

Conclusions. The arthroscopic intervention was successful in reducing pain in patients with unilateral anterior knee pain syndrome. However, muscle inhibition was still substantial 6 months following surgery and was significantly higher in the affected and contralateral limb than in normal subjects.

Keywords:  Anterior knee pain syndrome, Muscle inhibition, Quadriceps strengt, Interpolated twitch technique, Muscle stimulation, Arthroscopic knee surgery

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