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Quadriceps Inhibition Induced by an Experimental Knee Joint Effusion Affects Knee Joint Mechanics During a Single-Legged Drop Landing

Riann M. Palmieri-Smith, PhD, ATC^,,,*, Jennifer Kreinbrink, James A. Ashton-Miller, PhD^,||,¶ and Edward M. Wojtys, MD^,

From the Division of Kinesiology, the Department of Orthopaedic Surgery, the Sports Injury Prevention Center, the ^|| Department of Mechanical Engineering, and the ^¶ Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan

^* Address correspondence to Riann M. Palmieri-Smith, PhD, ATC, Assistant Professor, Athletic Training, Movement Science, and Orthopaedics, 3060D CCRB, 401 Washtenaw Avenue, Division of Kinesiology, University of Michigan, Ann Arbor, Michigan 48109 (e-mail: riannp{at}umich.edu).

Background: Arthrogenic quadriceps muscle inhibition accompanies knee joint effusion and impedes rehabilitation after knee joint injury.

Hypothesis: We hypothesized that an experimentally induced knee joint effusion would cause arthrogenic quadriceps muscle inhibition and lead to increased ground reaction forces, as well as sagittal plane knee angles and moments, during a single-legged drop landing.

Study Design: Controlled laboratory study.

Methods: Nine subjects (4 women and 5 men) underwent 4 conditions (no effusion, lidocaine injection, "low" effusion [30 mL], and "high" effusion [60 mL]) and then performed a single-legged drop landing. Lower extremity muscle activity, peak sagittal plane knee flexion angles, net sagittal plane knee moments, and peak ground reaction forces were measured.

Results: Vastus medialis and lateralis activity were decreased during the low and high effusion conditions (P < .05). However, increases in peak ground reaction forces and decreases in peak knee flexion angle and net knee extension moments occurred only during the high effusion condition (P < .05).

Conclusions: Knee joint effusion induced quadriceps inhibition and altered knee joint mechanics during a landing task. Subjects landed with larger ground reaction forces and in greater knee extension, thereby suggesting that more force will be transferred to the knee joint and its passive restraints when quadriceps inhibition is present.

Clinical Relevance: Knee joint effusion results in arthrogenic quadriceps muscle inhibition, increasing loading about the knee that may potentially increase the risk of future knee joint trauma or degeneration.

Key Words: muscle activation • swelling • knee • injury

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