{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:19:12Z","timestamp":1783437552228,"version":"3.54.6"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study is to determine the prevalence of arthrogenic muscle inhibition (AMI) after total knee arthroplasty (TKA) and to identify independent risk factors associated with its persistence during the early post\u2010operative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective monocentric study included 229 consecutive patients undergoing primary TKA between January 2024 and May 2025. AMI was assessed pre\u2010operatively and post\u2010operatively at 30 and 60 days using the Sonnery\u2010Cottet (SANTI) clinical classification by trained rehabilitation physicians. Although not specifically validated in TKA patients, this classification was used due to the absence of a validated alternative. Multivariate logistic regression analyses were performed to identify factors associated with AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      51.1% were male with a mean age at surgery of 70.7\u2009\u00b1\u20099.6. Pre\u2010operatively, 9.2% of patients showed signs of AMI. The post\u2010operative prevalence was 44.5% at 30 days and decreased to 19.2% at 60 days. Independent risk factors for AMI at 30 days were body mass index\u2009\u2265\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (odds ratio [OR] 1.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), symptom duration\u2009\u2265\u20094 years (OR 2.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), pre\u2010operative AMI (OR 6.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), post\u2010operative morphine use (OR 2.15;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and pre\u2010operative neutral limb alignment (hip\u2013knee\u2013ankle 175\u00b0\u2013185\u00b0) (OR 0.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). At 60 days, AMI persistence was associated with age\u2009\u2265\u200970 years (OR 3.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), pre\u2010operative AMI (OR 4.41;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), Visual Analogue Scale\u2009\u2265\u20097 at Day 7 (OR 3.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044) and AMI at 30 days (OR 15.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AMI is a frequent issue after TKA, affecting 45% of patients at 1 month and 20% at 2 months. Its occurrence is associated with pre\u2010operative inhibition, obesity, chronic symptoms, post\u2010operative pain and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70518","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:09:27Z","timestamp":1783436967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early arthrogenic muscle inhibition is the dominant predictor of persistent quadriceps inhibition after total knee arthroplasty"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2774-1170","authenticated-orcid":false,"given":"Marc","family":"Barrera Uso","sequence":"first","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7893-6488","authenticated-orcid":false,"given":"Jean\u2010Marie","family":"Fayard","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1624-1824","authenticated-orcid":false,"given":"Thais Dutra","family":"Vieira","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louka","family":"Bondoux","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4985-1610","authenticated-orcid":false,"given":"Tarik Ait Si","family":"Selmi","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9957-751X","authenticated-orcid":false,"given":"Michel","family":"Bonnin","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alajji","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0902-5760","authenticated-orcid":false,"given":"Elliot","family":"Sappey\u2010Marinier","sequence":"additional","affiliation":[{"name":"Ramsay Sant\u00e9, H\u00f4pital Priv\u00e9 Jean Mermoz, Centre Orthop\u00e9dique Santy, FIFA Medical Center of Excellence Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/art.24182","article-title":"Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis","volume":"60","author":"Amin S","year":"2009","journal-title":"Arthritis 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Mise au point sur l'inhibition motrice d'origine centrale dans les suites d'une entorse du genou. 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