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The American Journal of Sports Medicine 29:83-87 (2001)
© 2001 American Orthopaedic Society for Sports Medicine

Direct Evidence of the Anterior Cruciate Ligament-Hamstring Reflex Arc in Humans

Eiichi Tsuda, MD{dagger}, Yoshihisa Okamura, MD, Hironori Otsuka, MD, Takashi Komatsu, MD and Satoshi Tokuya, MD

Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki, Japan

Presented at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, July 1998.

{dagger} Address correspondence and reprint requests to Eiichi Tsuda, MD, Department of Orthopaedic Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan

It has been emphasized that the anterior cruciate ligament plays an important role in the proprioceptive feedback system. The anterior cruciate ligament-hamstring reflex has been revealed in animal experiments, but it has not been established in humans. The purpose of this study was to demonstrate direct evidence of the anterior cruciate ligament-hamstring reflex arc. Nine knees in nine healthy subjects were investigated. The anterior cruciate ligament was stimulated by the use of wire electrodes inserted using an arthroscopic technique. Electromyographic signals from the biceps femoris and the semitendinosus muscles were recorded with surface electrodes. The change in electromyographic activity was analyzed after electrical stimulation in the normal knee condition, and again after intraarticular sensation had been interrupted with a local anesthetic. After electrical stimulation, subjects demonstrated increased electromyographic activity of the hamstring muscles in the normal knee condition. This response indicates the existence of an anterior cruciate ligament-hamstring reflex arc. Conversely, there was no change in activity for the hamstring muscle in the anesthetized knee because the afferent impulse from the neural elements of the anterior cruciate ligament had been removed.




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