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OBJECTIVE: The purpose of this investigation was to estimate bilateral neuromuscular activity in the vastus medialis on induction of a unilateral knee joint effusion. DESIGN: Eight subjects each were assigned to effusion or control groups. The effusion group had 60 ml of sterile saline injected into their superolateral knee joint capsules. The control group rested for 8 mins. Bilateral recruitment curves for the Hoffmann reflex (H-reflex) and muscle response (M-wave) were obtained before and 10, 20, and 30 mins after the effusion or rest. The maximum H-reflex (Hmax), maximum M-wave (Mmax), and the Hmax/Mmax ratio were utilized for data analysis. RESULTS: Both Hmax and Hmax/Mmax ratios decreased from the baseline measure in the effused vastus medialis, whereas no changes were detected on the contralateral side. Effused subjects demonstrated decreased motoneuron pool excitability in the effused limb, whereas control subjects did not differ from baseline. CONCLUSIONS: Knee joint effusion results in ipsilateral but not contralateral impairment of quadriceps function. Rehabilitation protocols after knee joint injury should focus on ipsilateral neuromuscular and mechanical alterations that occur as the result of joint damage. [ABSTRACT FROM AUTHOR]