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Article Title

LEAN MASS AND MUSCLE MORPHOLOGY OF M. QUADRICEPS FEMORIS AFTER KNEE ARTHROSCOPY

Abstract

Ashley A. Herda1, Traci Smiley2, Kyle Martin2, Kyle Veazey2, Christopher J. Cleary1, and Bryan M. Vopat2,3

1University of Kansas, Department of Health, Sport, and Exercise Sciences, Overland Park, Kansas; 2University of Kansas Health Systems, Sports Medicine and Performance Center, Overland Park, Kansas; 3University of Kansas Health Systems, Department of Orthopedic Surgery and Sports Medicine, Overland Park, Kansas

PURPOSE: The purpose of this investigation was to document the progressive changes in muscle following knee arthroscopy. METHODS: Seven males (mean ± SD: age (yrs): 18.3±1.3; height (cm): 185.1±6.6; body mass (kg): 83.2±8.7) were observed before and up to 12-weeks after knee arthroscopy. The patients data was collected using a retrospective chart review and intermittent ultrasound monitoring to quantify muscle mass cross-sectional area (mCSA) of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM). Imaging was conducted using a diagnostic ultrasound with linear array probe and transverse plane imaging software. The treatment provided to patients included the standard of care with pre-and post-operative consultation and education on treatment plan, twice weekly physical therapy (PT) sessions, and, as necessary, blood flow restriction therapy (BRFT) during the sessions. The time points of capture included 2-, 6-, and 12-weeks post-operative PT visits. Data analyses include three, (2 X 3) two-way repeated measures ANOVAs (OP vs. NO) X (2W vs. 6W vs. 12W) for each mCSA. Level of significance was set at an alpha of 0.05 for all analyses. RESULTS: The 2-way ANOVAs resulted in no significant interaction for VL and VM mCSA (p=0.398 and p=0.301, respectively), however there was a main effect for time (p<0.001 and p<0.001, respectively) and leg (p=0.01 and p=0.01, respectively). Follow-up analyses indicated there was a drop in mCSA from 2W to 12W and 6W to 12W (p=0.016, mean difference=4.0 cm2 and p=0.006, mean difference=5.1 cm2, respectively) for VL and 2W to 12W (p=0.030, mean difference=2.4 cm2) for VM. Additionally, OP was smaller than NO across times (VL: p=0.001, mean difference=7.3 cm2; VM: p=0.006, mean difference=4.73 cm2). There was no interaction for RF mCSA (p=0.708), nor was there a main effect for time (p=0.882) or leg (p=0.062). CONCLUSIONS: These preliminary data suggest all superficial quadriceps muscles significantly atrophy through the 12-weeks of PT post knee arthroscopy. These first 6-12 weeks seem to be a critical time where rapid atrophy is occurring. Implementation of the most restorative treatments, such as BFRT, may be most beneficial if they extend beyond 12 weeks.

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