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Andrew J Cosgarea

Publications and source records attributed to Andrew J Cosgarea.

20 records · Page 2Linked to original sources

The soleus muscle acts as an agonist for the anterior cruciate ligament. An in vitro experimental study.

BACKGROUND: Although the quadriceps muscles are known antagonists for the anterior cruciate ligament and the hamstring muscles are known agonists, the influence of the calf muscles on knee stability is not well understood. HYPOTHESIS: The soleus muscle acts as an anterior cruciate ligament agonist and the gastrocnemius muscle acts as an anterior cruciate ligament antagonist. STUDY DESIGN: Controlled laboratory study. METHODS: Six cadaveric knees were tested with individual and combined activation of the gastrocnemius and soleus muscles to determine the influence of simulated muscle contraction on tibiofemoral motion. RESULTS: At all flexion angles, applying the soleus muscle force tended to translate the tibia posteriorly, whereas applying the gastrocnemius muscle force tended to translate the tibia anteriorly. Applying the soleus and gastrocnemius muscle forces together also tended to translate the tibia anteriorly. The average anterior and posterior tibial translations were greatest at 50 degrees of flexion. CONCLUSIONS: The soleus muscle is capable of acting as an agonist for the anterior cruciate ligament and the gastrocnemius muscle can act as an antagonist. CLINICAL RELEVANCE: A better understanding of the agonistic behavior of the soleus muscle on the anterior cruciate ligament may lead to the development of training and rehabilitation strategies that could reduce the incidence of injury and improve function in both patients with anterior cruciate ligament deficiency and patients who have undergone anterior cruciate ligament reconstruction.

Aged↗

Saphenous neuritis: a poorly understood cause of medial knee pain.

Saphenous neuritis is a painful condition caused by either irritation or compression at the adductor canal or elsewhere along the course of the saphenous nerve. The condition also may be associated with surgical or nonsurgical trauma to the nerve, especially at the medial or anterior aspect of the knee. Saphenous neuritis can imitate other pathology around the knee, particularly a medial meniscal tear or osteoarthritis. Unrecognized saphenous neuritis can confuse the patient's clinical picture, complicate treatment, and compromise results. As an isolated entity, saphenous neuritis may appear in conjunction with other common problems, such as osteoarthritis and patellofemoral pain syndrome, and it can have an indolent and protracted course. Its clinical appearance is characterized by allodynia along the course of the saphenous nerve. The diagnosis is confirmed by relief of symptoms after injection of the affected area with local anesthetic. Initial treatment can include non-surgical symptomatic care, treatment of associated pathology, and diagnostic or therapeutic injections of local anesthetic. In recalcitrant cases, surgical decompression and neurectomy are potential options. The key to treatment is prompt recognition; palpation of the saphenous nerve should be part of every routine examination of the knee.

Decompression, Surgical↗