Loss of neuromuscular control related to motion in the acutely ACL-injured knee:: an experimental study

被引:12
作者
Bonsfills, N. [1 ]
Gomez-Barrena, E. [2 ]
Raygoza, J. J. [3 ]
Nunez, A. [4 ]
机构
[1] Hosp Univ La Paz, Hosp Infantil, Unidad Ortoped Pediat, Madrid 28046, Spain
[2] Univ Autonoma Madrid, Fac Med, Dept Cirugia, Serv Cirugia Ortoped & Traumatol,Fdn Jimenez Diaz, Madrid, Spain
[3] Univ Autonoma Madrid, Escuela Politecn Super, Madrid, Spain
[4] Univ Autonoma Madrid, Fac Med, Dept Anat Histol & Neurociencia, Madrid, Spain
关键词
anterior cruciate ligament; neuromuscular control; ultrasonomicrometry; strain gauges;
D O I
10.1007/s00421-008-0729-3
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Ligamentomuscular and muscular stretch reflexes are known to contribute to knee joint stability. After anterior cruciate ligament (ACL) injury, a more intense and adjusted muscular response is required to maintain joint stability, but this neuromuscular control of the knee has not been clearly proved. The aim of the study is to record electromyography (EMG) signal and muscular fibre length variations in quadriceps and hamstrings of the knee with and without ACL, and to analyze and integrate the ligament strain and the muscular reaction to forced anterior tibial translation (ATT). In 17 knees from 12 cats, EMG electrodes and ultrasonomicrometry crystals were inserted into four main periarticular muscles, with strain gauges on periarticular ligament insertions. Their output signal was compared before and after ACL surgical section in series of ATT (at 90 degrees and 30 degrees knee flexion), and also during knee flexion and extension. Linear regression analysis was performed between the EMG signal and muscular fibre length variations, and between the EMG signal and the strain on ligament insertions, in the search of this reflex neuromuscular response. In the ACL deficient knees, the studied muscles showed a poor adjustment to motion of EMG firing, inversely to controls. The muscle stretch reflexes showed poorer correlation with post-peak EMG activity than the ligaments. ATT control depended mainly on hamstrings activity in control knees, whereas in unstable knees, quadriceps activity was associated with more tibial translation. Acute ACL-deficient knees showed poor neuromuscular control with weak ligamentomuscular reflexes and no muscular stretch reflexes, suggesting the ineffectiveness of acute muscular reaction to provide early mechanical knee stabilization after injury.
引用
收藏
页码:567 / 577
页数:11
相关论文
共 51 条
[1]   Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense [J].
Adachi, N ;
Ochi, M ;
Uchio, Y ;
Iwasa, J ;
Ryoke, K ;
Kuriwaka, M .
ACTA ORTHOPAEDICA SCANDINAVICA, 2002, 73 (03) :330-334
[2]  
Ageberg Eva, 2002, J Electromyogr Kinesiol, V12, P205, DOI 10.1016/S1050-6411(02)00022-6
[3]   Muscle force and its role in joint dynamic stability [J].
An, KN .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2002, (403) :S37-S42
[4]   The science of anterior cruciate ligament rehabilitation [J].
Beynnon, BA ;
Johnson, RJ ;
Fleming, BC .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2002, (402) :9-20
[5]   Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis [J].
Biau, DJ ;
Tournoux, C ;
Katsahian, S ;
Schranz, PJ ;
Nizard, RS .
BRITISH MEDICAL JOURNAL, 2006, 332 (7548) :995-998
[6]   Future directions for the analysis of musculoskeletal design and locomotor performance [J].
Biewener, AA .
JOURNAL OF MORPHOLOGY, 2002, 252 (01) :38-51
[7]  
Biewener AA, 2001, J EXP BIOL, V204, P1745
[8]   Proprioception in the ACL-ruptured knee:: The contribution of the medial collateral ligament and patellar ligament.: An in vivo experimental study in the cat [J].
Bonsfills, N. ;
Raygoza, J. J. ;
Boemo, E. ;
Garrido, J. ;
Nunez, A. ;
Gomez-Barrena, E. .
KNEE, 2007, 14 (01) :39-45
[9]   Evidence for differential control of tibial position in perturbed unilateral stance after acute ACL rupture [J].
Chmielewski, TL ;
Ramsey, DK ;
Snyder-Mackler, L .
JOURNAL OF ORTHOPAEDIC RESEARCH, 2005, 23 (01) :54-60
[10]   Development of dynamic knee stability after acute ACL injury [J].
Chmielewski, TL ;
Rudolph, KS ;
Snyder-Mackler, L .
JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY, 2002, 12 (04) :267-274