The Effects of Anterior Cruciate Ligament Reconstruction on Individual Quadriceps Muscle Thickness and Circulating Biomarkers

Int J Environ Res Public Health. 2019 Dec 4;16(24):4895. doi: 10.3390/ijerph16244895.

Abstract

Anterior cruciate ligament reconstruction (ACLR) frequently results in quadriceps atrophy. The present study investigated the effect of ACLR on the muscle thickness of the different constituent muscles of the quadriceps and circulating biomarkers related to muscle atrophy and hypertrophy. Fourteen subjects underwent anterior cruciate ligament reconstruction following injury. Quadriceps muscle thicknesses were measured using ultrasound, and circulating biomarkers in the blood were measured using enzyme-linked immunosorbent assays (ELISAs) at the preoperative visit (PRE) and at two postoperative visits (PO1, PO2) in the early stages post-surgery. Differences between time points were analyzed using one-way repeated measures analysis of variance (ANOVA) tests. The most important finding was that severe muscle atrophy occurred in the vastus intermedius (VI) after ACLR (PRE: 20.45 ± 6.82 mm, PO1: 16.05 ± 6.13 mm, PO2: 13.18 ± 4.7 mm, F = 59.0, p < 0.001). Furthermore, the myostatin level was slightly increased, and IGF-1 was significantly reduced throughout the entire period. Therefore, we suggest that inducing selective hypertrophy in the vastus intermedius during the process of rehabilitation would be important for athletes and individuals who engage in explosive sports. Moreover, inhibiting myostatin level increases and maintaining IGF-1 levels in the early phase of recovery after ACLR to prevent muscle atrophy may provide a pharmaceutical option for rehabilitation after anterior cruciate ligament injury.

Keywords: anterior cruciate ligament reconstruction; muscle atrophy; myostatin; quadriceps; vastus intermedius.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anterior Cruciate Ligament Injuries / blood
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / adverse effects*
  • Biomarkers / blood
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Male
  • Muscle Strength
  • Muscular Atrophy / blood
  • Muscular Atrophy / diagnosis
  • Muscular Atrophy / etiology*
  • Muscular Atrophy / pathology
  • Myostatin / blood
  • Postoperative Complications* / blood
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / pathology
  • Quadriceps Muscle / metabolism
  • Quadriceps Muscle / pathology*
  • Young Adult

Substances

  • Biomarkers
  • IGF1 protein, human
  • MSTN protein, human
  • Myostatin
  • Insulin-Like Growth Factor I