Selective muscle activation following electrical stimulation of the collateral ligaments of the human knee joint.

The objective of this study was to establish the presence of a local neurosensory reflex are from mechanoreceptors in human collateral ligaments and joint capsule to knee muscles and to determine if these muscles could be selectively activated as varus or valgus stabilizers using randomized trials. All studies were performed in the research department laboratories. Eleven subjects were recruited from the university staff and students based on no prior history of knee ailments. Subjects laid supine on an experimentation table as a current-modulated electrical stimulation was provided through the medial (MCL) or lateral collateral (LCL) knee ligaments. Latency of activation was measured for seven muscles, four by surface electrodes (semitendinosus, biceps femoris long head, vastus medialis, and lateralis), and three by intramuscular electrodes (sartorius, gracilis, tensor fascia lata). In the protocol, selective activation was defined as the relative increase in the activity of four muscles with medial moment arms following MCL stimulation compared with corresponding activity following LCL stimulation. For lateral muscles, the opposite was assumed (ie, that more activity would follow LCL than MCL stimulation). Monte Carlo simulations were performed on the data to determine significant selective muscle activation (p < .05). Statistically significant increases in activation were observed, most consistently, in the vastus medialis following MCL stimulation and in the vastus lateralis following LCL stimulation. These results suggest that a neurosensory reflex are from ligament mechanoreceptors may provide varus and valgus stabilization and knee muscles may be selectively activated to counter varus or valgus loads.

[1]  E. Delagi,et al.  Anatomical guide for the electromyographer : the limbs and trunk /by Edward F. Delagi [et al.] ; illustrated by Phyllis B. Hammond, Aldo O. Perotto, and Hugh Thomas , 2005 .

[2]  U Proske,et al.  Acute inflammation of the knee joint in the cat alters responses of flexor motoneurons to leg movements. , 1988, Journal of neurophysiology.

[3]  H. Schaible,et al.  Activation of groups III and IV sensory units in medial articular nerve by local mechanical stimulation of knee joint. , 1983, Journal of neurophysiology.

[4]  A H Hoffman,et al.  Properties of Ruffini afferents revealed by stress analysis of isolated sections of cat knee capsule. , 1982, Journal of neurophysiology.

[5]  L. Huston,et al.  Neuromuscular Performance in Normal and Anterior Cruciate Ligament-Deficient Lower Extremities , 1994, The American journal of sports medicine.

[6]  B. Stener Experimental evaluation of the hypothesis of ligamento-muscular protective reflexes. I. A method for adequate stimulation of tension receptors in the medial collateral ligament of the knee joint of the cat, and studies of the innervation of the ligament. , 2008, Acta physiologica Scandinavica. Supplementum.

[7]  S. Andersson,et al.  Experimental evaluation of the hypothesis of ligamento-muscular protective reflexes. II. A study in cat using the medial collateral ligament of the knee joint. , 2008, Acta Physiologica Scandinavica Supplementum.

[8]  E. Radin,et al.  Synovial membrane and cartilage changes in experimental osteoarthrosis , 1988, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[9]  B. Wyke,et al.  Articular contributions to limb muscle reflexes. The effects of partial neurectomy of the knee‐joint on postural reflexes , 1966, The British journal of surgery.

[10]  F.E. Zajac,et al.  An interactive graphics-based model of the lower extremity to study orthopaedic surgical procedures , 1990, IEEE Transactions on Biomedical Engineering.

[11]  L. Micheli,et al.  Mechanoreceptors in human cruciate ligaments. A histological study. , 1984, The Journal of bone and joint surgery. American volume.

[12]  S. Skoglund,et al.  On the reflex effects from the knee joint of the cat. , 1960, Acta physiologica Scandinavica.

[13]  S. Woo,et al.  Treatment of the medial collateral ligament injury , 1987, The American journal of sports medicine.

[14]  E. Dabezies,et al.  Neural anatomy of the human anterior cruciate ligament. , 1987, The Journal of bone and joint surgery. American volume.

[15]  M L Zimny,et al.  Mechanoreceptors in articular tissues. , 1988, The American journal of anatomy.

[16]  R J Johnson,et al.  The role of the musculature in injuries to the medial collateral ligament. , 1979, The Journal of bone and joint surgery. American volume.

[17]  S. Woo,et al.  Effects of surgical treatment and immobilization on the healing of the medial collateral ligament: a long-term multidisciplinary study. , 1990, Connective tissue research.

[18]  R. D'ambrosia,et al.  The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability , 1987, The American journal of sports medicine.

[19]  F. P. Kendall,et al.  Muscles, testing and function , 1971 .

[20]  J. Iles,et al.  Reflex actions of knee joint afferents during contraction of the human quadriceps. , 1990, Clinical physiology.

[21]  H. Johansson,et al.  A sensory role for the cruciate ligaments. , 1991, Clinical orthopaedics and related research.

[22]  R. Cailliet Knee pain and disability , 1973 .

[23]  T. Andriacchi,et al.  Interaction between active and passive knee stabilizers during level walking , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[24]  B. Stener,et al.  Electromyographic investigation of reflex effects upon effects upon stretching the partially ruptured medial collateral ligament of the knee joint. , 1962, Acta chirurgica Scandinavica.

[25]  Docteur Paul G. J. Maquet,et al.  Biomechanics of the Knee , 1984, Springer Berlin Heidelberg.

[26]  T P Andriacchi,et al.  The anterior cruciate ligament-deficient knee with varus alignment , 1992, The American journal of sports medicine.

[27]  K. Fogarty,et al.  Properties of Golgi-Mazzoni afferents in cat knee joint capsule, as revealed by mechanical studies of isolated joint capsule. , 1982, Journal of Neurophysiology.

[28]  W. Seering,et al.  The function of the primary ligaments of the knee in anterior-posterior and medial-lateral motions. , 1980, Journal of biomechanics.

[29]  T Sinkjaer,et al.  Mechanical and electromyographic responses to stretch of the human ankle extensors. , 1991, Journal of neurophysiology.