KNEE-JOINT EFFUSION AND QUADRICEPS REFLEX INHIBITION IN MAN

  • 1 January 1984
    • journal article
    • research article
    • Vol. 65  (4) , 171-177
Abstract
The role of effusion in producing the reflex inhibition, and subsequent atrophy, of quadriceps musculature following knee trauma was studied. In particular, consideration was given to determining the extent, threshold and linearity of inhibition of the motoneuron pool induced by experimental introduction of small increments of 0.9% physiological saline (up to 60 ml) into the joint space of the knee in 10 healthy subjects. Inhibition of the quadriceps muscle motoneuron pool was indirectly assessed through recording Hoffmann (H) reflexes evoked from vastus medialis, lateralis and rectus femoris. All 10 subjects showed a significant (P < 0.05) reduction in H-reflex amplitude following the introduction of saline: vastus medialis reduced to 55.7 .+-. 4.3% of its control 0ml value, rectus femoris to 69.1 .+-. 6.1% and vastus lateralis to 65.3 .+-. 4.0%. Post hoc analyses of the H-reflex amplitudes at each increment of simulated effusion revealed the threshold for reflex inhibition of the vastus medialis to be between 20 and 30 ml of saline and for rectus femoris and vastus lateralis to be between 50 and 60 ml. These procedures were repeated on 8 subjects following an injection of the anesthetic lidocaine (1%) to the intra-articular space of their knee joints but there was no significant reduction in H-reflex amplitude. Linear relationships were found to adequately describe the relationships between the volume of effusion and intra-articular pressure; and volume of effusion and reduction in H-reflex amplitude. On the basis of the contrasting effects produced by the saline in the anesthetized and unanesthetized knee, quadriceps inhibition is mediated through the afferent activity of intracapsular receptors. Clinical ramifications of these findings are discussed.

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