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Original Article

Arthrogenic Muscle Inhibition: A Study on the Correlation Between Neuromuscular Dysfunction and Mobility limitations Following Cruciate Ligament Reconstruction Surgery
JingYao Jiang1, DongLiang Zhang1, HongFeng Ye1, TianXiong Qiu1, JunFeng Zhu1, ZhenXing Zhang1
1.
Department of Orthopedics, The Second Hospital of Longyan, Longyan City, Fujian Province, China
Abstract
Objectives: To explore arthrogenic muscle inhibition (AMI)’s impact on mobility after anterior/posterior cruciate ligament (ACL/PCL) reconstruction, identify early predictors of postoperative stiffness, and inform clinical rehabilitation. Methods: In this prospective cohort study, 146 ACL/PCL reconstruction patients were split into stiff (passive flexion 5° at 12 weeks [T2]) and non-stiff groups. Preoperative data, knee function (ROM, gait, muscle strength, proprioception) and AMI indicators (quadriceps VA, H/M ratio) were assessed at 4 weeks (T1) and T2. Boruta, multivariate logistic, and multiple linear regression analyzed predictors. Results: The stiff group had longer injury-to-surgery intervals, higher patellar tendon use, worse ROM/gait/strength/AMI metrics at T1-T2. The four most important predictors for T2 stiffness were T1 passive flexion, extension deficit, H/M ratio, and VA; T1 H/M (OR=4.82) and extension deficit (OR=3.85) were major risks. T2 H/M correlated negatively with passive flexion (β=-0.73), T1 VA with extension deficit (β=-0.38). The logistic model demonstrated good predictive performance (optimism-corrected C-index = 0.890). Conclusions: AMI associates with post-ACL/PCL mobility issues. Four early indicators predict T2 stiffness, with H/M impacting flexion and VA affecting extension, guiding personalized rehabilitation.
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