KSSTA - 2026-04-14 - Journal Article
Preoperative and postoperative risk factors for arthrogenic muscle inhibition in anterior cruciate ligament reconstruction: A retrospective study.
Morel G, Rambaud A, Testa R, Moron H, Ollier E, Stordeur A, Philippot R, Neri T
Topics
Key Takeaway
Joint effusion (OR=8.97) and bucket-handle meniscal tears (OR=5.24) are the strongest preoperative predictors of AMI before ACLR, while lateral femorotibial cartilage lesions (OR=8.63), female sex (OR=2.98), and preoperative AMI (OR=3.56) independently predict postoperative AMI at 90 days.
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Summary
This retrospective cohort study identified preoperative and postoperative risk factors for arthrogenic muscle inhibition (AMI) in 169 patients undergoing hamstring autograft ACLR with concomitant anterolateral ligament reconstruction. AMI was present in 33.7% overall, with prevalence of 15% preoperatively, 22% at D45, and 18% at D90. Multivariable logistic regression identified joint effusion and bucket-handle tears as preoperative triggers, and lateral cartilage lesions, female sex, and preoperative AMI as independent postoperative predictors.
Key Limitation
The entire cohort received concomitant anterolateral ligament reconstruction, preventing generalizability to standard isolated ACLR and introducing a confounding surgical variable that may independently affect postoperative inflammation and AMI.
Original Abstract
PURPOSE
This study aimed to identify preoperative and postoperative risk factors associated with the development of arthrogenic muscle inhibition (AMI) in patients undergoing anterior cruciate ligament reconstruction (ACLR). The hypothesis was that distinct risk factors contribute to the occurrence of preoperative and postoperative AMI.
METHODS
A retrospective cohort study included 169 patients who underwent ACLR using a hamstring autograft combined with anterolateral ligament reconstruction between November 2022 and December 2023. AMI was clinically assessed preoperatively (t0), and at 45 days (D45) and 90 days (D90) postoperatively. Demographic, clinical and perioperative variables were collected. A combination of descriptive statistics and inferential tests was used, followed by univariate and stepwise multivariable logistic regression to identify independent predictors of AMI.
RESULTS
AMI was observed in 33.7% of patients. Its prevalence was 15% at t0, 22% at D45 and 18% at D90. Preoperatively, patients with AMI demonstrated reduced knee flexion range (p < 0.001) and a shorter delay between injury and consultation (p < 0.001); AMI was significantly associated with joint effusion (odds ratio [OR] = 8.97; p < 0.001) and bucket-handle meniscal tears (OR = 5.24; p = 0.016). Postoperatively, significant predictors included female sex (OR = 2.98; p = 0.009), lateral femorotibial cartilage lesions (OR = 8.63; p = 0.004) and preoperative AMI (OR = 3.56; p = 0.008). Pain intensity was not significantly associated with AMI at any assessment point (not significant [n.s.]).
CONCLUSION
AMI affects approximately one-third of patients undergoing ACLR and may persist for at least three months postoperatively. Distinct preoperative and postoperative risk factors were identified, with preoperative AMI strongly predicting its persistence. Joint effusion and specific meniscal lesions appear to act as preoperative triggers, whereas cartilage damage and sex may influence postoperative evolution. Early identification and management of modifiable risk factors, particularly before surgery, may help optimize rehabilitation and limit the persistence of AMI after ACLR.
LEVEL OF EVIDENCE
Level III.