{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T23:08:46Z","timestamp":1779145726723,"version":"3.51.4"},"reference-count":56,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anterior cruciate ligament reconstruction induces deleterious neuromuscular\n                    alterations. Musculoskeletal ultrasonography provides an accessible method to\n                    quantify muscle size and quality in patients with anterior cruciate ligament\n                    reconstruction who suffer from persistent skeletal muscle atrophy. This study\n                    compares rectus femoris and vastus intermedius muscle thicknesses and echo\n                    intensities using extended field-of-view ultrasonography in individuals with a\n                    history of anterior cruciate ligament reconstruction versus non-injured\n                    controls. Twenty-six individuals with previous anterior cruciate ligament\n                    reconstruction and 20 controls were participated in this study. Extended\n                    field-of-view ultrasonography was used to analyze the muscle thickness in the\n                    proximal, middle, and distal regions of the thigh, while the echo intensity was\n                    measured to assess the muscle quality. Findings indicate significant asymmetries\n                    in the muscle thickness (p&lt;0.01 and\n                    \u03b7\n               p\n               2=0.312) and echo intensity (p=0.024 and\n                        \u03b7\n               p\n               2=0.111) for the anterior cruciate ligament\n                    reconstruction group, favoring the uninvolved leg, with no site-specific\n                    differences between groups. Results show muscle-specific size differences, with\n                    greater vastus intermedius muscle thickness than rectus femoris muscle thickness\n                    in controls (p&lt;0.01 and d=0.609), but no difference between\n                    muscles in either leg of the anterior cruciate ligament reconstruction group\n                        (p&gt;0.05 and d=0.094). Overall, these results highlight\n                    unique skeletal muscle changes between the biarticular rectus femoris and the\n                    monoarticular vastus intermedius following anterior cruciate ligament\n                    reconstruction, likely reflecting postoperative deficiencies in knee extensor\n                    function.<\/jats:p>","DOI":"10.1055\/a-2604-7425","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T19:07:58Z","timestamp":1746731278000},"page":"1016-1023","source":"Crossref","is-referenced-by-count":1,"title":["Rectus femoris and vastus intermedius muscle asymmetries following\n                    ACL reconstruction"],"prefix":"10.1055","volume":"46","author":[{"given":"Manal","family":"Fasih","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Texas Christian\n                    University Anne Burnett Marion School of Medicine, Fort Worth, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Voskuil","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, Lakeland University,\n                    Plymouth, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Rivas","sequence":"additional","affiliation":[{"name":"Neuromuscular Physiology Laboratory, Texas Christian\n                    University, Fort Worth, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bobby","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Texas Health Resources,\n                    Arlington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin","family":"Nadolny","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Texas Health Resources,\n                    Arlington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Texas Health Sports Medicine, Arlington,\n                    USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0874-0110","authenticated-orcid":false,"given":"Joshua","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Texas Christian\n                    University Anne Burnett Marion School of Medicine, Fort Worth, USA"},{"name":"Department of Kinesiology, Kansas State University,\n                    Manhattan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1177\/1941738120912846","article-title":"One in 5 Athletes Sustain Reinjury Upon Return to High-Risk 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Approach"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2325967117745279","DOI":"10.1177\/2325967117745279","article-title":"Clinical Factors That Predict a Second ACL Injury After ACL Reconstruction and\n                    Return to Sport: Preliminary Development of a Clinical Decision Algorithm","volume":"5","author":"M V Paterno","year":"2017","journal-title":"Orthop J Sports Med"},{"key":"ref8","first-page":"262","article-title":"Strength, Functional Outcome, and Postural Stability After Anterior Cruciate\n                    Ligament Reconstruction","volume":"37","author":"C G Mattacola","year":"2002","journal-title":"J Athl Train"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1136\/bjsports-2016-096031","article-title":"Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction:\n                    the Delaware-Oslo ACL cohort study","volume":"50","author":"H Grindem","year":"2016","journal-title":"Br J Sports Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2557","DOI":"10.1177\/0363546519865537","article-title":"Factors Associated With a Return to Preinjury Level of Sport Performance After\n                    Anterior Cruciate Ligament Reconstruction Surgery","volume":"47","author":"K E Webster","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1249\/MSS.0000000000000560","article-title":"Strength Asymmetry and Landing Mechanics at Return to Sport after Anterior\n                    Cruciate Ligament Reconstruction","volume":"47","author":"L C Schmitt","year":"2015","journal-title":"Med Sci Sports Exerc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"59","DOI":"10.2519\/josptopen.2024.1242","article-title":"Musculoskeletal Tissue Asymmetries Following Anterior Cruciate Ligament\n                    Reconstruction","volume":"3","author":"O. K. Anderson","year":"2025","journal-title":"JOSPT Open"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1177\/1941738119898210","article-title":"Longitudinal Assessment of Quadriceps Muscle Morphology Before and After\n                    Anterior Cruciate Ligament Reconstruction and Its Associations With\n                    Patient-Reported Outcomes","volume":"12","author":"S A Garcia","year":"2020","journal-title":"Sports Health Multidiscip Approach"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"246","DOI":"10.4085\/1062-6050-38-19","article-title":"Quadriceps Muscle Size, Quality, and Strength and Self-Reported Function in\n                    Individuals With Anterior Cruciate Ligament Reconstruction","volume":"55","author":"S A Garcia","year":"2020","journal-title":"J Athl Train"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1123\/jsr.2016-0141","article-title":"MRI-Based Assessment of Lower-Extremity Muscle 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Vastus Lateralis Muscle as the\n                    Result of ACL Injury and Reconstruction","volume":"98","author":"B Noehren","year":"2016","journal-title":"J Bone Jt Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00421-020-04556-6","article-title":"Echo intensity as an indicator of skeletal muscle quality: applications,\n                    methodology, and future directions","volume":"121","author":"M S Stock","year":"2021","journal-title":"Eur J Appl Physiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e0198304","DOI":"10.1371\/journal.pone.0198304","article-title":"Resistance training does not induce uniform adaptations to quadriceps","volume":"13","author":"G T Mangine","year":"2018","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1046\/j.1365-201X.1996.483230000.x","article-title":"Human quadriceps cross-sectional area, torque and neural activation during 6\n                    months strength training","volume":"157","author":"M V Narici","year":"1996","journal-title":"Acta Physiol Scand"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1519\/JSC.0000000000004722","article-title":"Determining Changes in Muscle Size and Architecture After Exercise Training: One\n                    Site Does Not Fit all","volume":"38","author":"J P Nunes","year":"2024","journal-title":"J Strength Cond Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1080\/09593985.2022.2135980","article-title":"Musculoskeletal ultrasound imaging of proximal and distal hamstrings cross\n                    sectional area in individuals with history of anterior cruciate ligament\n                    reconstruction","volume":"40","author":"A\u00de Hjaltad\u00f3ttir","year":"2024","journal-title":"Physiother Theory 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Kinesiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2140","DOI":"10.1249\/MSS.0000000000002691","article-title":"The Human Muscle Size and Strength Relationship: Effects of Architecture, Muscle\n                    Force, and Measurement Location","volume":"53","author":"T G Balshaw","year":"2021","journal-title":"Med Sci Sports Exerc"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1139\/apnm-2019-0601","article-title":"Variability of regional quadriceps echo intensity in active\n                    young men with and without subcutaneous fat correction","volume":"45","author":"D J Oranchuk","year":"2020","journal-title":"Appl\n                    Physiol Nutr Metab"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1139\/apnm-2020-0114","article-title":"Age-, sex-, and region-specific differences in skeletal muscle size and\n                    quality","volume":"45","author":"M S Stock","year":"2020","journal-title":"Appl Physiol Nutr Metab"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2485","DOI":"10.1002\/jor.25910","article-title":"Beyond weakness: Exploring intramuscular fat and quadriceps atrophy in ACLR\n                    recovery","volume":"42","author":"M S White","year":"2024","journal-title":"J Orthop Res"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1111\/j.1600-0838.2011.01417.x","article-title":"Functional and muscle morphometric effects of ACL reconstruction. A\n                    prospective CT study with 1 year follow-up","volume":"23","author":"M Lindstr\u00f6m","year":"2013","journal-title":"Scand J Med Sci Sports"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jsams.2014.12.009","article-title":"Muscle atrophy contributes to quadriceps weakness after anterior cruciate\n                    ligament reconstruction","volume":"19","author":"A C Thomas","year":"2016","journal-title":"J Sci Med Sport"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"238","DOI":"10.2519\/jospt.1997.26.5.238","article-title":"Thigh Muscle Size and Strength After Anterior Cruciate Ligament Reconstruction\n                    and Rehabilitation","volume":"26","author":"G A Arangio","year":"1997","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"303","DOI":"10.4085\/1062-6050-49.5.06","article-title":"Persistent Neuromuscular and Corticomotor Quadriceps Asymmetry After Anterior\n                    Cruciate Ligament Reconstruction","volume":"50","author":"C M Kuenze","year":"2015","journal-title":"J Athl Train"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1177\/1941738118822739","article-title":"Quadriceps Strength and Volitional Activation After Anterior Cruciate Ligament\n                    Reconstruction: A Systematic Review and Meta-analysis","volume":"11","author":"C Lisee","year":"2019","journal-title":"Sports Health Multidiscip Approach"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1302\/0301-620X.83B8.0831104","article-title":"Effects of reconstruction of the anterior cruciate ligament on voluntary\n                    activation of quadriceps femoris: A PROSPECTIVE TWITCH INTERPOLATION STUDY","volume":"83-B","author":"D Urbach","year":"2001","journal-title":"J Bone Joint Surg Br"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"475","DOI":"10.4085\/1062-6050-102-17","article-title":"Quadriceps Neuromuscular Function in Patients With Anterior Cruciate Ligament\n                    Reconstruction With or Without Knee Osteoarthritis: A Cross-Sectional Study","volume":"53","author":"G E Norte","year":"2018","journal-title":"J Athl Train"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/00006534-199907000-00015","article-title":"Neurovascular anatomy of the rectus femoris muscle related to functioning muscle\n                    transfer","volume":"104","author":"D Yang","year":"1999","journal-title":"Plast Reconstr Surg"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1016\/s0003-9993(03)00029-7","article-title":"Motor branch of the rectus femoris: anatomic location for selective motor branch\n                    block in stiff-legged gait","volume":"84","author":"D H Sung","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.jelekin.2018.06.011","article-title":"Additional insight into biarticular muscle function: The influence of hip flexor\n                    fatigue on rectus femoris activity at the knee","volume":"42","author":"J C Carr","year":"2018","journal-title":"J Electromyogr Kinesiol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1080\/17461391.2022.2056520","article-title":"Arthrogenic muscle inhibition manifests in thigh musculature motor unit\n                    characteristics after anterior cruciate ligament injury","volume":"23","author":"N D Schilaty","year":"2023","journal-title":"Eur J Sport Sci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.semarthrit.2009.10.001","article-title":"Quadriceps Arthrogenic Muscle Inhibition: Neural Mechanisms and Treatment\n                    Perspectives","volume":"40","author":"D A Rice","year":"2010","journal-title":"Semin Arthritis Rheum"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.csm.2008.02.001","article-title":"Maximizing Quadriceps Strength After ACL Reconstruction","volume":"27","author":"R M Palmieri-Smith","year":"2008","journal-title":"Clin Sports Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.csm.2008.03.004","article-title":"Neuromuscular Consequences of Anterior Cruciate Ligament Injury","volume":"27","author":"C D Ingersoll","year":"2008","journal-title":"Clin Sports Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1111\/sms.12435","article-title":"Quadriceps neural alterations in anterior cruciate ligament reconstructed\n                    patients: A 6-month longitudinal investigation","volume":"25","author":"A S Lepley","year":"2015","journal-title":"Scand J Med Sci Sports"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1177\/0363546515578252","article-title":"Quadriceps Strength Asymmetry After Anterior Cruciate Ligament Reconstruction\n                    Alters Knee Joint Biomechanics and Functional Performance at Time of Return to\n                    Activity","volume":"43","author":"R M Palmieri-Smith","year":"2015","journal-title":"Am J Sports Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"5103","DOI":"10.1113\/JP282014","article-title":"Deficit in knee extension strength following anterior cruciate ligament\n                    reconstruction is explained by a reduced neural drive to the vasti muscles","volume":"599","author":"S Nuccio","year":"2021","journal-title":"J Physiol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"76","DOI":"10.2519\/jospt.2014.4876","article-title":"Differences in Neuromuscular Control and Quadriceps Morphology Between Potential\n                    Copers and Noncopers Following Anterior Cruciate Ligament Injury","volume":"44","author":"T D MacLeod","year":"2014","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"2590","DOI":"10.1016\/j.ultrasmedbio.2023.08.027","article-title":"Rectus Femoris Ultrasound Echo Intensity Is a Valid Estimate of Percent\n                    Intramuscular Fat in Patients Following Anterior Cruciate Ligament\n                    Reconstruction","volume":"49","author":"C Grozier","year":"2023","journal-title":"Ultrasound Med Biol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1016\/j.ultrasmedbio.2008.09.016","article-title":"Skeletal Muscle Ultrasound: Correlation Between Fibrous Tissue and Echo\n                    Intensity","volume":"35","author":"S Pillen","year":"2009","journal-title":"Ultrasound Med 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Andrushko","year":"2023","journal-title":"Br J Sports Med"}],"container-title":["International Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2604-7425.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T23:58:19Z","timestamp":1763596699000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2604-7425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":56,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,11,19]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2604-7425","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4622","1439-3964"],"issn-type":[{"value":"0172-4622","type":"print"},{"value":"1439-3964","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5,8]]},"published":{"date-parts":[[2025,5,8]]}}}