Treatment of Arthrogenic-Muscle-Inhibition in patients after knee-surgery with Motion-Activated-Neuromuscular stimulation – a case-series

Abstract

Arthrogenic muscle inhibition (AMI) presents a persistent challenge in postoperative knee rehabilitation and is often resistant to standard care. This case series examines the efficacy of Motion-Activated Neuromuscular Electrical Stimulation (mNMES) in addressing AMI refractory to rehabilitation after ACL (revision) surgery, patellar dislocation, trochleoplasty, or conservative treatment of the patellofemoral pain syndrome. Eight patients who had undergone extensive unsuccessful rehabilitation received six weeks of a novel mNMES treatment regimen. Outcome assessments included patient-reported outcome measures (PROMs) and AMI classification. Results revealed significant improvements in pain reduction, knee function, and AMI reduction. Despite study limitations, mNMES demonstrated promising outcomes and could be used as an adjunct to standard rehabilitation, offering potential for enhancing postoperative outcomes in patients refractory to conventional therapy. Further research is required to validate these findings and optimise treatment protocols.

Zusammenfassung

Die arthrogene Muskelhemmung (AMI) stellt eine anhaltende Herausforderung in der postoperativen Knie-Rehabilitation dar und ist oft refraktär gegenüber der konservativen Standardbehandlung. In dieser Fallserie wird die Wirksamkeit einer bewegungsaktivierten neuromuskulären Elektrostimulation (mNMES) bei persistierender AMI untersucht, die sich nach einer VKB (-Revisions) -Operation, Patellaluxation, Trochleoplastik oder konservativen Behandlung des patellofemoralen Schmerzsyndroms entwickelt hat. Acht Patienten, die eine umfangreiche trainingstherapeutische Rehabilitation absolviert hatten, unterzogen sich 6 Wochen lang der neuartigen mNMES-Behandlung. Die Ergebnisse wurden anhand von Fragebogeninstrumenten (PROMs) und der Änderung der AMI-Klassifizierung im Prä-post-Vergleich bewertet. Die Ergebnisse zeigten signifikante Verbesserungen bei der Schmerzreduktion, der Kniefunktion und der AMI-Reduktion. Trotz der Limitationen dieser Studie zeigte mNMES vielversprechende Ergebnisse und könnte als Ergänzung zur Standardrehabilitation eingesetzt werden, um die postoperativen Ergebnisse bei Patienten zu verbessern, die auf eine konventionelle Therapie nicht ansprechen. Weitere Untersuchungen sind erforderlich, um diese Ergebnisse zu bestätigen und die Behandlungsprotokolle zu optimieren.

Keywords

arthrogenic muscle inhibition - neuromuscular stimulation - patellofemoral pain - anterior knee pain - anterior cruciate ligament revision surgery - trochleaplasty - knee pacemaker

Schlüsselwörter

Arthrogene Muskelhemmung - neuromuskuläre Stimulation - patellofemorale Schmerzen - vordere Knieschmerzen - Revision des vorderen Kreuzbandes

Publication History

Received: 16 May 2024

Accepted after revision: 15 July 2024

Article published online:
04 September 2024

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