Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

Toth MJ, Tourville TW, Voigt TB, Choquette RH, Anair BM, Falcone MJ, Failla MJ, Stevens-Lapslaey JE, Endres NK, Slauterbeck JR, Beynnon BD · The American Journal of Sports Medicine

Reconstruction shrank single muscle fibres and cut their contractility across all fibre types in the injured leg by three weeks (P < 0.01 to 0.001). Stimulation reduced that fibre atrophy (P < 0.01), acting on fast-twitch type II fibres, and preserved contractility in slow-twitch type I fibres, raising maximal contractile velocity and preserving power, but not in type II fibres. No difference in whole-muscle strength was detectable at six months.

Population

Twenty-one patients (9 men, 12 women) completing a blinded, sham-controlled trial after anterior cruciate ligament reconstruction, with muscle biopsies from the injured and uninjured legs

Intervention

Neuromuscular electrical stimulation started soon after injury and continued to three weeks after surgery

Comparator

Sham stimulation in the same patients' protocol

Limitations

Twenty-one people, and the cellular findings did not translate into a whole-muscle strength difference at six months. The endpoint is muscle tissue, not joint tissue. Funded by grant AR069199 to two of the authors.