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J Appl Physiol 105: 800-804, 2008. First published June 12, 2008; doi:10.1152/japplphysiol.00961.2007
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Quadriceps cross-sectional area changes in young healthy men with different magnitude of Q angle

Aikaterini E. Tsakoniti,1 Christoforos A. Stoupis,2 and Spyros I. Athanasopoulos1

1Sports Physical Therapy Laboratory, Department of Sports Medicine and Biology of Exercise, Faculty of Physical Education and Sports Science, National and Kapodestrian University of Athens, Greece; and 2Department of Radiology, University of Berne and Spital Maennedorf, Berne, Switzerland

Submitted 12 September 2007 ; accepted in final form 10 June 2008

Knee pain and dysfunction have been often associated with an ineffective pull of the patella by the vastus medialis (VM) relative to the vastus lateralis (VL), particularly in individuals with knee joint malalignment. Such changes in muscular behavior may be attributed to muscle inhibition and/or atrophy that precedes the onset of symptoms. The aim of this study was to investigate possible effects of knee joint malalignment, indicated by a high quadriceps (Q) angle (HQ angle >15°), on the anatomic cross-sectional area (aCSA) of the entire quadriceps and its individual parts, in a group of 17 young asymptomatic men compared with a group of 19 asymptomatic individuals with low Q angle (LQ angle <15°). The aCSA of the entire quadriceps (TQ), VM, VL, vastus intermedius (VI), rectus femoris (RF), and patellar tendon (PT) were measured during static and dynamic magnetic resonance imaging (MRI) with the quadriceps relaxed and under contraction, respectively. A statistically significant lower aCSA was obtained in the HQ angle group, compared with the LQ angle group, for the TQ, VL, and VI in both static (TQ = 9.9%, VL = 12.9%, and VI = 9.1%; P < 0.05) and dynamic imaging (TQ = 10.7%, P < 0.001; VL = 13.4%, P < 0.01; and VI = 9.8%, P < 0.05) and the aCSA of the VM in dynamic MRI (11.9%; P < 0.01). The muscle atrophy obtained in the HQ angle group may be the result of a protective mechanism that inhibits and progressively adapts muscle behavior to reduce abnormal loading and wear of joint structures.

magnetic resonance imaging; knee; muscle inhibition; malalignment



Address for reprint requests and other correspondence: A. E. Tsakoniti, Sports Physical Therapy Laboratory, Dept. of Sports Medicine and Biology of Exercise, Faculty of Physical Education and Sports Science, National and Kapodestrian Univ. of Athens, 8 Isminis St., 172 37, Daphne, Greece (e-mail: ktsakon{at}phed.uoa.gr)







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