Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg

Rennerfelt, Kajsa; Zhang, Qiuxia; Karlsson, Jón; Styf, Jorma

doi:10.2106/jbjs.n.01280

Cited by 10 publications

(21 citation statements)

References 16 publications

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“…IMP was measured continuously with a catheter in the test leg of the subject using a micro-capillary infusion system (Hemo 4; Siemens, Erlangen, Germany) and monitor (Siemens SC 9000; Siemens, Gothenburg, Sweden), which have been used previously in studies on the same muscle compartment [17, 18]. The IMP measurements were randomized to the left or right leg before the test, and the same leg was monitored at both sessions for each subject.…”

Section: Methodsmentioning

confidence: 99%

“…Oxygenation of muscle tissue is directly related to the balance between oxygen consumption and oxygen supply. Near-infrared spectroscopy (NIRS) provides continuous information about the absolute level of muscle oxygenation in an exercising muscle [17, 19]. The NIRS probe unit consists of two detector photodiodes and three laser-emitting diodes held 4 cm apart.…”

Section: Methodsmentioning

confidence: 99%

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Effects of Exercise Compression Stockings on Anterior Muscle Compartment Pressure and Oxygenation During Running: A Randomized Crossover Trial Conducted in Healthy Recreational Runners

et al. 2019

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Background Exercise compression garments have increased in popularity among athletes at all levels during the last 10 years. However, the scientific grounds for this are unclear. The purpose of the present study was to examine the effect of wearing exercise compression stockings (CS) on the anterior compartment pressure, oxygenation of the tibialis anterior muscle, and early blood biomarkers change for muscle damage during a 10-km treadmill run in healthy subjects. Methods Twenty healthy subjects completed two identical treadmill runs, with or without CS. The subjects were randomized regarding the order in which the sessions were performed. Intramuscular pressure (IMP) and muscle oxygenation in the one leg were continuously measured before, during, and after running sessions. Blood samples were collected just before and directly after these sessions and analyzed for myoglobin and creatine kinase concentrations. Results The use of CS during running resulted in significantly higher IMP (by 22 ± 3.1 mmHg on average) and lower tissue oxygenation index (by 11 ± 1.8%) compared to running without CS ( p < 0.001). In addition, the Δ change in median serum myoglobin concentration measured before and after running was significantly higher when CS were used: 58 (9‒210) µg/L as compared to 38 (0‒196) µg/L with no CS ( p = 0.04). No difference in post-running early serum creatine kinase concentration was observed between using CS and not using CS. Conclusion Wearing exercise CS during and following a 10-km treadmill run elevated IMP and reduced muscle tissue oxygenation in the anterior compartment of healthy runners. Furthermore, the use of exercise CS did not prevent early exercise-induced muscle damage, as measured by serum biomarkers.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effects of Exercise Compression Stockings on Anterior Muscle Compartment Pressure and Oxygenation During Running: A Randomized Crossover Trial Conducted in Healthy Recreational Runners

et al. 2019

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“…Van den Brand et al [6] evaluierten ebenfalls die NIRS als nichtinvasive Alternative zur intrakompartimentellen Druckmessung.…”

Section: Nahinfrarotspektroskopieunclassified

“…Eine aktuellere Arbeit von Rennerfelt [6] steht in Kontroverse zu den Arbeiten von van den Brand und Mohler, sodass der Stellenwert der Nahinfrarotspektroskopie in der Diagnostik des funktionellen Komartmentsyndroms weiterhin offen bleibt und weiterhin kritisch beobachtet oder weitergehend untersucht werden sollte. Bei unserem Patientengut hat sich eine seitenvergleichende Messung unter symmetrischer Belastung als hilfreich erwiesen.…”

Section: Nahinfrarotspektroskopieunclassified

“…So kann die Druckerhöhung zu einem arteriellen Spasmus, einer Obstruktion der Mikrozirkulation sowie einem Kollaps der Arteriolen und Venen führen. Qvarfordt[10] konnte eine erhöhte Serum-Laktat-Konzentration und einen erhöhten Wassergehalt des M. tibialis anterior nachweisen, was sich nach Fasziotomie wieder normalisierte.Van den Brand[6] konnte 2004 eine Verminderung des Sauerstoff-Partialdrucks im Bereich der Tibialis-Anterior-Loge bei Patienten mit chronischem Kompartmentsyndrom unter Belastung nachweisen. Qvarfordt[10] undStyf…”

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Das chronische Kompartmentsyndrom

Gösele-Koppenburg

2018

Sportverletz Sportschaden

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Chronic compartment syndromes are a rare, but frequently overlooked cause of pain in the locomotor system. Their aetiology is still not fully elucidated. There is an imbalance of muscle volume and space in the compartment. Thickening of the fascia and decreased elasticity lead to a pathological increase in pressure in the compartment under load. Chronic compartment syndromes are found in the foot, lower leg, thigh, forearm, hand, and even the spine. Bilateral compartment syndromes are very common (80 %). The main symptoms are pain in the compartment under physical activity. Compartment pressure measurement is the gold standard examination. Other diagnostic procedures are near-infrared spectroscopy, MRI and ultrasound. As conse rvative treatment often fails, surgical treatment becomes necessary. Different techniques are described in the literature. We prefer an endoscopy-assisted minimally-invasive approach.

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Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

Sjöcrona,

Lindorsson,

Rennerfelt

2024

J. exp. orthop.

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PurposeTo identify patient characteristics associated with forearm chronic exertional compartment syndrome (CECS) and to demonstrate the distribution of intramuscular pressure (IMP) values at 1 min postexercise in a cohort of patients with exercise‐induced forearm pain.MethodsA consecutive series of 99 patients seeking orthopaedic consultation for chronic exertional forearm pain underwent IMP measurements between 2010 and 2023. The diagnosis of CECS was confirmed (n = 34) or ruled out (n = 65) based on the patient's history, clinical examination and IMP measurements.ResultsThere were significantly more male patients in the CECS group than in the group of patients where the diagnosis was ruled out. Furthermore, a significantly higher proportion of the CECS patients had been previously treated for CECS of the lower legs. The most common occupation was office worker (21%), followed by craftsperson (18%). The most common main physical activities were strength training (21%) and cycling (15%). The median (range) 1‐min postexercise IMP values for patients with CECS were 34 (23–68) mmHg for the flexor compartment and 32 (25–67) mmHg for the extensor compartment.ConclusionThis study demonstrates a more general population of CECS patients compared to previous studies. Notably, more than a fifth of the CECS patients had previously been treated for CECS in the lower legs. Importantly, considering the 95% confidence interval for IMP values in patients without CECS, the most used IMP cutoff value for diagnosing CECS appears to be too high for the forearm compartments.Level of EvidenceLevel II.

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Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg

Abstract: Changes in muscle oxygen saturation during and after an exercise test that elicits leg pain cannot be used to distinguish between patients with CACS and patients with other causes of exercise-induced leg pain.

Cited by 10 publications

References 16 publications

Effects of Exercise Compression Stockings on Anterior Muscle Compartment Pressure and Oxygenation During Running: A Randomized Crossover Trial Conducted in Healthy Recreational Runners

Effects of Exercise Compression Stockings on Anterior Muscle Compartment Pressure and Oxygenation During Running: A Randomized Crossover Trial Conducted in Healthy Recreational Runners

Das chronische Kompartmentsyndrom

Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

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