Seitz Andreas Martin, Murrmann Miriam, Ignatius Anita, Dürselen Lutz, Friemert Benedikt, von Lübken Falk
Institute of Orthopedic Research and Biomechanics Institute of Orthopedic Research and Biomechanics Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany.
Department of Trauma and Orthopedic Surgery, Hospital of the Federal Armed Forces Ulm, Ulm, Germany.
Arthrosc Sports Med Rehabil. 2021 Feb 23;3(2):e555-e563. doi: 10.1016/j.asmr.2020.12.009. eCollection 2021 Apr.
To investigate neuromuscular electromyographic response of the of the upper and lower leg muscles after the application of an intraoperative, isolated mechanical stimulus of the capsuloligamentous structures, including the anterior (ACL) and posterior cruciate ligaments (PCL), lateral (LM) and medial menisci (MM), plica mediopatellaris (PM), and Hoffa's fat pat (HFP).
The electromyographic response of the upper and lower leg muscles (M. rectus femoris; M. vastus medialis; M. semitendinosus; M. biceps femoris; M. gastrocnemius lateralis) of 15 male patients were measured after an isolated mechanical stimulus of the capsuloligamentous structures during an arthroscopic intervention using a customized intraoperative setup. Target parameters were the short (SLR; <30 milliseconds) and medium latency responses (MLR; >30 milliseconds) after the mechanically-induced trigger.
The ACL, PCL, LM, and MM displayed high interindividual reproducibility of >76%. The MM was the only structure indicating both an SLR and MLR for all muscles. Although signals could be detected, there was no reproducibility in electromyographic signal activation for the HFP. The most rapid MLR was observed for the PM (quadriceps: 37 milliseconds).
Each stimulated structure displayed an individual MLR response, which allowed us to create neuromapping combining the anatomical and quantitative representations of the individual muscular activation patterns after isolated mechanical stimulation of the capsuloligamentous knee joint structures, corroborating our hypothesis.
Diagnostic - Level II.
在对包括前交叉韧带（ACL）和后交叉韧带（PCL）、外侧半月板（LM）和内侧半月板（MM）、髌内侧皱襞（PM）以及Hoffa脂肪垫（HFP）在内的关节囊韧带结构施加术中孤立机械刺激后，研究上下腿部肌肉的神经肌肉肌电图反应。
在关节镜干预过程中，使用定制的术中装置对15名男性患者的关节囊韧带结构进行孤立机械刺激后，测量其上下腿部肌肉（股直肌；股内侧肌；半腱肌；股二头肌；腓肠肌外侧头）的肌电图反应。目标参数是机械诱发触发后的短潜伏期反应（SLR；<30毫秒）和中潜伏期反应（MLR；>30毫秒）。
ACL、PCL、LM和MM显示出>76%的高个体间重复性。MM是唯一对所有肌肉均显示出SLR和MLR的结构。尽管可以检测到信号，但HFP的肌电图信号激活没有重复性。观察到PM的MLR最快（股四头肌：37毫秒）。
每个受刺激结构均显示出个体MLR反应，这使我们能够创建神经图谱，将膝关节囊韧带结构孤立机械刺激后个体肌肉激活模式的解剖学和定量表示相结合，证实了我们的假设。
诊断性——二级。
