Muscle activations to stabilize the knee following arthroscopic partial meniscectomy

Abstract

Background: Arthroscopic partial meniscectomy patients are at increased risk of developing knee osteoarthritis. This population, particularly those with weaker quadriceps, have larger-than-normal knee adduction moments, which tend to load the medial tibiofemoral joint. Larger knee adduction moments predict progression of knee osteoarthritis and may contribute to the increased risk in meniscectomy patients. Increased muscle activity to support these large moments may further elevate articular loads. We examined a) the muscle activity while walking in a meniscectomy and control population, and b) the relationship between knee strength and muscle activity. Methods: Gait patterns and knee extension strength were assessed in 89 male arthroscopic partial meniscectomy patients and 30 age-matched healthy controls. Surface electromyography was recorded during walking from ten muscles that cross the knee. Findings: Compared to controls, the meniscectomy group displayed greater muscle activity while walking, with increased hamstrings activation, yet no difference in directed co-contraction. While controlling for age, no differences were found between meniscectomy subjects with weak and normal knee extension strength, in hamstrings activity, quadriceps activity or directed co-contraction. Interpretation: The generalised increase in non-directed muscle activity in the meniscectomy group may provide enhanced muscular support of larger-than-normal knee adduction moments. Higher levels of antagonist co-contraction may increase muscle forces and, subsequently, joint articular loads, contributing to the increased risk of developing knee osteoarthritis following arthroscopic partial meniscectomy.