The Knee · 2025
Vastus medialis onset activation in patients who underwent medial patellofemoral ligament reconstruction with and without tibial tubercular osteotomy.
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Oba Kensuke, Ono Ryosuke, Ota Moeka, Fujioka Shohei, Kato Takuya, Sakaki Yoshinari, Sasaki Kazuhiro, Kura Hideji
Аннотация
BACKGROUND: Medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercular osteotomy (TTO) are common surgical treatments for patellar dislocation. However, the impact of isolated MPFLR and MPFLR combined with TTO (MPFLR+TTO) on vastus medialis oblique (VMO) onset activation remains unclear. This study investigated the VMO onset activation relative to the vastus lateralis (VL) among patients undergoing isolated MPFLR, MPFLR+TTO, and healthy controls during maximum voluntary isometric knee extension.
METHODS: This study included 25 patients who underwent MPFLR, divided into two groups: isolated MPFLR (n = 12, age: 22.6 ± 11.9, follow-up time: 24.0 ± 16.8 months) and MPFLR+TTO (n = 15, age: 28.2 ± 12.8, follow-up time: 25.2 ± 15.6 months). A control group of 11 healthy adults (22 knees, age: 28.4 ± 1.3) was also included. Electromyographic (EMG) activities of the VMO and VL muscles were recorded during maximal voluntary isometric knee extensions at 30°, 60°, and 90° of flexion. Differences in VMO onset activation relative to VL (VMO-VL) were analyzed.
RESULTS: At 30° knee flexion, the MPFLR group showed a significant delay in VMO activation compared to healthy controls (p < 0.001). In contrast, the MPFLR+TTO group exhibited no significant differences in VMO activation relative to healthy controls. No significant differences were observed at 60° and 90° flexion among all groups.
CONCLUSION: Isolated MPFLR delayed VMO activation relative to VL. In contrast, MPFLR+TTO balanced the onset activation between VMO and VL. These findings highlight the need for targeted rehabilitation programs to address delayed VMO activation in patients undergoing isolated MPFLR.
METHODS: This study included 25 patients who underwent MPFLR, divided into two groups: isolated MPFLR (n = 12, age: 22.6 ± 11.9, follow-up time: 24.0 ± 16.8 months) and MPFLR+TTO (n = 15, age: 28.2 ± 12.8, follow-up time: 25.2 ± 15.6 months). A control group of 11 healthy adults (22 knees, age: 28.4 ± 1.3) was also included. Electromyographic (EMG) activities of the VMO and VL muscles were recorded during maximal voluntary isometric knee extensions at 30°, 60°, and 90° of flexion. Differences in VMO onset activation relative to VL (VMO-VL) were analyzed.
RESULTS: At 30° knee flexion, the MPFLR group showed a significant delay in VMO activation compared to healthy controls (p < 0.001). In contrast, the MPFLR+TTO group exhibited no significant differences in VMO activation relative to healthy controls. No significant differences were observed at 60° and 90° flexion among all groups.
CONCLUSION: Isolated MPFLR delayed VMO activation relative to VL. In contrast, MPFLR+TTO balanced the onset activation between VMO and VL. These findings highlight the need for targeted rehabilitation programs to address delayed VMO activation in patients undergoing isolated MPFLR.