Longitudinal Assessment of Quadriceps Muscle Morphology Before and After Anterior Cruciate Ligament Reconstruction and Its Associations With Patient-Reported Outcomes.

Background: Reductions in muscle size are common after anterior cruciate ligament reconstruction (ACLR) and may contribute to suboptimal patient outcomes. However, few studies have quantified postoperative alterations in muscle quality and evaluated its associations with patient-reported function.Hy...

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Publicado en:Sports Health: A Multidisciplinary Approach Vol. 12; no. 3; pp. 271 - 279
Autores principales: Garcia, Steven A., Curran, Michael T., Palmieri-Smith, Riann M.
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. May/Jun2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Sage Publications Inc.
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        atl: Longitudinal Assessment of Quadriceps Muscle Morphology Before and After Anterior Cruciate Ligament Reconstruction and Its Associations With Patient-Reported Outcomes.
      aug:
        au:
          Garcia, Steven A.
          Curran, Michael T.
          Palmieri-Smith, Riann M.
        affil: School of Kinesiology, University of Michigan, Ann Arbor, Michigan
      sug:
        subj:
          Anterior Cruciate Ligament Reconstruction Adverse Effects
          Quadriceps Muscles Pathology
          Anterior Cruciate Ligament Reconstruction Rehabilitation
          Muscle Weakness
          Muscular Atrophy
          Postoperative Complications
          Muscle Weakness Etiology
          Quadriceps Muscles
          Muscular Atrophy Etiology
          Adolescence
          Ultrasonography
          Ferrans and Powers Quality of Life Index
          Scales
          Adolescent: 13-18 years
      ab: Background: Reductions in muscle size are common after anterior cruciate ligament reconstruction (ACLR) and may contribute to suboptimal patient outcomes. However, few studies have quantified postoperative alterations in muscle quality and evaluated its associations with patient-reported function.Hypotheses: Rectus femoris cross-sectional area (CSA) will decrease postoperatively but improve at return to activity (RTA), rectus femoris muscle quality (percentage fat [PF]) will increase postoperatively and be greater at RTA compared with preoperative values, and rectus femoris CSA and PF will be associated with International Knee Documentation Committee (IKDC) scores at both postoperative time points.Study Design: Case series.Level Of Evidence: Level 4.Methods: A total of 26 individuals who sustained an ACL injury and underwent reconstructive surgery were evaluated preoperatively (T0), 9 weeks post-ACLR (T1), and at RTA. Rectus femoris CSA and PF were evaluated bilaterally via ultrasound imaging, and patient-reported function was assessed using the IKDC score.Results: Bilateral reductions in rectus femoris CSA were noted from T0 to T1 (P < 0.01). Only the uninvolved limb returned to preoperative CSA (P = 0.80), as the involved limb failed to return to preoperative levels at RTA (P = 0.04). No significant changes in rectus femoris PF were observed across time points (P > 0.05). Lesser PF (P < 0.01) but not CSA (P = 0.75) was associated with higher IKDC score at T1. Lesser PF (P = 0.04) and greater CSA (P = 0.05) was associated with higher IKDC score at RTA.Conclusion: Substantial atrophy occurs bilaterally after ACLR, and the involved limb does not return to preoperative muscle size despite the patient completing rehabilitation. Quadriceps muscle morphology is associated with patient-reported function and may be an important rehabilitation target after ACLR.Clinical Relevance: Quadriceps atrophy and poor muscle quality may contribute to suboptimal patient functioning and quadriceps dysfunction and may be important in RTA decision making. Assessing muscle morphology using ultrasound may be a feasible and clinically beneficial tool in patients after ACLR.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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