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Published on: March 1, 2024
Arthrogenic Muscle Inhibition: A Study on the Correlation Between Neuromuscular Dysfunction and Mobility limitations
JingYao Jiang1, DongLiang Zhang1, HongFeng Ye1
1Department of Orthopedics, The Second Hospital of Longyan, Longyan City, Fujian Province, China.
Journal of Musculoskeletal & Neuronal Interactions
|June 1, 2026
Summary
Arthrogenic muscle inhibition (AMI) impacts knee mobility after ACL/PCL reconstruction. Early indicators like H/M ratio and VA predict stiffness, guiding personalized rehabilitation for better patient outcomes.
Area of Science:
- Orthopedics
- Sports Medicine
- Rehabilitation Science
Background:
- Arthrogenic muscle inhibition (AMI) is a significant factor affecting knee function post-anterior/posterior cruciate ligament (ACL/PCL) reconstruction.
- Understanding AMI's role is crucial for optimizing rehabilitation protocols and improving patient mobility outcomes.
Purpose of the Study:
- To investigate the impact of AMI on mobility following ACL/PCL reconstruction.
- To identify early predictors of postoperative knee stiffness.
- To inform the development of personalized clinical rehabilitation strategies.
Main Methods:
- A prospective cohort study involving 146 patients undergoing ACL/PCL reconstruction.
- Patients were classified into stiff and non-stiff groups based on range of motion and extension deficit at 12 weeks post-surgery.
- Preoperative and early postoperative (4 and 12 weeks) assessments included knee function (ROM, gait, strength, proprioception) and AMI indicators (quadriceps VA, H/M ratio).
- Statistical analyses included Boruta, multivariate logistic, and multiple linear regression to identify predictors of stiffness.
Main Results:
- Patients who developed stiffness had longer injury-to-surgery intervals and poorer functional metrics and AMI indicators at early postoperative stages.
- Key predictors for stiffness at 12 weeks included passive flexion, extension deficit, H/M ratio, and VA at 4 weeks.
- The H/M ratio (Odds Ratio = 4.82) and extension deficit (Odds Ratio = 3.85) at 4 weeks were significant risk factors for developing stiffness.
- A predictive model demonstrated strong performance (C-index = 0.890).
Conclusions:
- AMI is strongly associated with impaired mobility after ACL/PCL reconstruction.
- Four early indicators, specifically H/M ratio and quadriceps VA, can predict the development of knee stiffness.
- These findings support the use of early AMI assessment to tailor rehabilitation programs for improved functional recovery.