ArticleJournal of orthopaedic surgery and research2024
Assessment of arthrogenic quadriceps muscle inhibition by physical examination in the supine position during isometric contraction is feasible as demonstrated by electromyography: a cross-sectional study.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Cerebellar and Subcortical Connectivity Associated with Arthrogenic Muscle Inhibition After Acute ACL Rupture in Males: A Clinical and fMRI Study.Sports medicine - open · 2026Article
- FIRM-P separates knee phenotype from patient context in anterior cruciate ligament-related instability: A conceptual framework integrating arthrogenic muscle inhibition as a cross-domain modifier.Journal of experimental orthopaedics · 2026Article
- Effect of intravenous hydrocortisone and periarticular triamcinolone acetonide injection on quadriceps strength recovery in patients undergoing total knee arthroplasty: a prospective randomised controlled trial.Knee surgery & related research · 2026Article
- Rehabilitation of Arthrogenic Muscle Inhibition in Patients with Knee Osteoarthritis and after Knee Arthroplasty.Current reviews in musculoskeletal medicine · 2026Review
- Incidence and Risk Factors for Arthrogenic Muscle Inhibition in the Early Postoperative Period After ACL Reconstruction. A Cohort Study From the SANTI Study Group.Orthopaedic journal of sports medicine · 2026Article
- Arthrogenic muscle inhibition: A prevalent issue in knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Observational
- Evidence for arthrogenic inhibition of the gluteus medius after anterior cruciate ligament injury: A systematic review.Journal of experimental orthopaedics · 2025Article
- Think Outside the Block: Rehabilitation Continuum After ACL Reconstruction with Adaptive Macro-Blocks-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Clinical SANTI classification of arthrogenic muscle inhibition has an excellent inter-rater and intra-rater reliability in preoperative and post-operative anterior cruciate ligament rupture.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Observational
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6 authors.
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Abstract
backgroundPreventing severe arthrogenic muscle inhibition (AMI) after knee injury is critical for better prognosis. The novel Sonnery-Cottet classification of AMI enables the evaluation of AMI severity but requires validation. This study aimed to investigate the electromyography (EMG) patterns of leg muscles in the examination position from the classification during isometric contraction to confirm its validity. We hypothesised that the AMI pattern, which is characterised by quadriceps inhibition and hamstring hypercontraction, would be detectable in the supine position during isometric contraction.
methodsPatients with meniscal or knee ligament injuries were enrolled between August 2023 and May 2024. Surface EMG was assessed during submaximal voluntary isometric contractions (sMVIC) at 0° extension in the supine position for the vastus medialis (VM) and vastus lateralis (VL) muscles and at 20° flexion in the prone position for the semitendinosus (ST) and biceps femoris (BF) muscles. Reference values for normalisation were obtained from the EMG activity during the gait of the uninjured leg. The Kruskal-Wallis test was used to compare the activation patterns of the muscle groups within the same leg, and the post-hoc tests were conducted using the Mann-Whitney U test and Bonferroni correction.
resultsElectromyographic data of 40 patients with knee injuries were analyzed. During sMVIC, the extensor and flexor muscles of the injured leg showed distinct behaviours (P < 0.001), whereas the uninjured side did not (P = 0.144). In the injured leg, the VM differed significantly from the ST (P = 0.018), and the VL differed significantly from the ST and BF (P = 0.001 and P = 0.026, respectively). However, there were no statistically significant differences within the extensor muscle groups (VM and VL, P = 0.487) or flexor muscle groups (ST and BF, P = 0.377).
conclusionAMI was detectable in the examination position suggested by the Sonnery-Cottet classification. The flexor and extensor muscles of the injured leg exhibited distinct activation behaviours, with inhibition predominantly occurring in the quadriceps muscles, whereas the hamstrings showed excitation.
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