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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_8 | Pages 141 - 141
11 Apr 2023
du Moulin W Bourne M Diamond L Konrath J Vertullo C Lloyd D Saxby D
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Anterior cruciate ligament reconstruction (ACLR) using a semitendinosus (ST) autograft, with or without gracilis (GR), results in donor muscle atrophy and varied tendon regeneration. The effects of harvesting these muscles on muscle moment arm and torque generating capacity have not been well described. This study aimed to determine between-limb differences (ACLR vs uninjured contralateral) in muscle moment arm and torque generating capacity across a full range of hip and knee motions. A secondary analysis of magnetic resonance imaging was undertaken from 8 individuals with unilateral history of ST-GR ACLR with complete ST tendon regeneration. All hamstring muscles and ST tendons were manually segmented. Muscle length (cm), peak cross-sectional area (CSA) (cm. 2. ), and volume (cm. 3. ) were measured in ACLR and uninjured contralateral limbs. OpenSim was used to simulate and evaluate the mechanical consequences of changes in normalised moment arm (m) and torque generating capacity (N.m) between ACLR and uninjured contralateral limbs. Compared to uninjured contralateral limbs, regenerated ST tendon re-insertion varied proximal (+) (mean = 0.66cm, maximum = 3.44cm, minimum = −2.17cm, range = 5.61cm) and posterior (+) (mean = 0.38cm maximum = 0.71cm, minimum = 0.02cm, range = 0.69cm) locations relative to native anatomical positions. Compared to uninjured contralateral limbs, change in ST tendon insertion point in ACLR limbs resulted in 2.5% loss in peak moment arm and a 3.4% loss in peak torque generating capacity. Accounting for changes to both max isometric force and ST moment arm, the ST had a 14.8% loss in peak torque generating capacity. There are significant deficits in ST muscle morphology and insertion points following ST-GR ACLR. The ST atrophy and insertion point migration following ACLR may affect force transmission and distribution within the hamstrings and contribute to persistent deficits in knee flexor and internal rotator strength


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 166 - 166
1 Jul 2014
Flaxman T Smith A Benoit D
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Summary Statement. Using a weight-bearing force control task, age-related changes in muscle action were observed in osteoarthritic subjects, however, greater activation of rectus femoris and medial hamstring muscles in the OA group compared to control indicates greater cocontraction and varied stabilisation strategies. Introduction. Osteoarthritis (OA) is the most debilitating condition among older adults. OA is thought to be mechanically driven by altering the stabilising integrity of the joint. The main contributor to knee joint stability is that of muscular contraction. In cases where the history of a traumatic knee joint injury is not a causal factor, a change in muscle function, resulting in reduced strength and force control in believed to induce OA development and progression. Since age is also a determining factor of OA, the purpose of this study was to investigate the muscle activation patterns of young healthy adults (YC), older healthy adults (OC), and adults with OA during a standing isometric force control task. Patients & Methods. A force matching protocol was used to evaluate muscle activation patterns of 41 YC (23.1±1.9 years of age) 18 OC (59.7±5.14 years), and 19 OA (63.5±8.1 years). Subjects stood with their leg of interest fixed to a force platform and modulated ground reaction forces while exposing equal body weight to each leg. Surface electromyography (EMG) of 8 muscles that cross the knee joint, kinetics and kinematics were recorded while subjects generated 30% of their maximal force in 12 different directions, corresponding to various combinations of medial-lateral-anterior-posterior ground reaction forces. Processed EMG was normalised to previously recorded maximum voluntary isometric contraction (MVIC) and ensemble averaged into group means for each loading direction. Muscle activation patterns were displayed in EMG polar plots and were quantified with symmetry analyses, mean activation levels (X. EMG. ), directions (Φ), and specificity indices (SI). Group differences were tested with independent T-tests at the p<0.05 level. Results. Muscle activation patterns were similar between groups (i.e. symmetry and Φ). However, X. EMG. of 7 muscles was significantly greater in both the OA and OC groups compared to YC. OA group also demonstrated significantly greater X. EMG. in the rectus femoris and tensor fascia lata as well as lower SI in semitendinosus hamstrings compared to OC. Discussion/Conclusion. Our results indicate that regardless of loading direction, both OC and OA groups have greater levels of muscle co-contraction than YC. This is suggested to be an adaptive response to age-related changes in muscle strength and force control. Since individuals with OA have reduced muscle strength and force control compared to age-matched controls, our results suggest that the OA group's greater, less specific activation of knee joint muscles relative to the OC is this “stiffening” response adapted by the OA group, however, to an extent that may expose the joint to detrimental loading conditions, contributing to the progression of OA. Further investigation regarding age-related neuromuscular changes and their influence on joint loading conditions and development of OA is warranted


Bone & Joint Research
Vol. 6, Issue 1 | Pages 57 - 65
1 Jan 2017
Gumucio JP Flood MD Bedi A Kramer HF Russell AJ Mendias CL

Objectives

Rotator cuff tears are among the most frequent upper extremity injuries. Current treatment strategies do not address the poor quality of the muscle and tendon following chronic rotator cuff tears. Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that activates many genes that are important in skeletal muscle regeneration. HIF-1α is inhibited under normal physiological conditions by the HIF prolyl 4-hydroxylases (PHDs). In this study, we used a pharmacological PHD inhibitor, GSK1120360A, to enhance the activity of HIF-1α following the repair of a chronic cuff tear, and measured muscle fibre contractility, fibrosis, gene expression, and enthesis mechanics.

Methods

Chronic supraspinatus tears were induced in adult rats, and repaired 28 days later. Rats received 0 mg/kg, 3 mg/kg, or 10 mg/kg GSK1120360A daily. Collagen content, contractility, fibre type distribution and size, the expression of genes involved in fibrosis, lipid accumulation, atrophy and inflammation, and the mechanical properties of the enthesis were then assessed two weeks following surgical repair.