Effect of Age, Sex, and Injury on Regional Stresses and Resulting Growth of the Anterior Cruciate Ligament

年龄、性别和损伤对区域应力及其导致的前十字韧带生长的影响

• 批准号: 10407971
• 负责人: Danielle Howe
• 金额: $ 1.56万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2022-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10407971
• 关键词: Adolescence; Adolescent; Adult; Affect; Age; Animals; Anterior Cruciate Ligament; Area; Biological; Biomechanics; Cartilage; Child; Childhood; Clinical Treatment; Collagen; Computer Models; Computer Simulation; Computing Methodologies; Consensus; Data; Diagnosis; Elements; Family suidae; Female; GAG Gene; Geometry; Goals; Growth; Image; Imaging Techniques; Injury; Joints; Knee; Knee joint; Ligaments; Location; Long-Term Effects; Magnetic Resonance Imaging; Measures; Mechanics; Modeling; Modulus; Operative Surgical Procedures; Orthopedics; Outcome Study; Patients; Pattern; Play; Preventive measure; Property; Quality of life; Reconstructive Surgical Procedures; Research; Research Personnel; Robotics; Sex Differences; Specimen; Stifle joint; Stress; Techniques; Testing; Time; Tissues; Training; Youth; age effect; anterior cruciate ligament injury; base; experience; high risk; improved; in vivo; injured; kinematics; ligament injury; male; mechanical load; mechanical stimulus; pediatric patients; porcine model; quantitative imaging; reconstruction; response; sex; simulation; skeletal; tissue stress; treatment strategy; trend

PROJECT SUMMARY Pediatric anterior cruciate ligament (ACL) injuries and surgical intervention rates are rapidly increasing in recent years. Of particular concern, pediatric patients are approximately five times more likely than adults to experience a secondary ACL injury after surgical reconstruction. Further, sex plays a factor in injury rates, where females experience a higher risk of ACL injury than males during adolescence, but not childhood or adulthood. However, the mechanism of ACL injuries and the reasons behind these age and sex-related differences remain unclear. This is, in part, due to difficulty experimentally observing the ACL during injury and limited data regarding the function of the ACL and its anteromedial (AM) and posterolateral (PL) bundles throughout skeletal growth. ACL injuries likely occur when the ligament experiences high local stresses—forces concentrated over a small area. Preliminary data from our group has shown sex-dependent growth and function of the AM and PL bundles, so it seems likely that sex and age will impact the magnitude and location of local stresses within the ACL. Therefore, the objective of this proposal is to determine how age and sex impact local stresses in the ACL throughout skeletal growth and how partial ACL injury may affect growth and remodeling of the remaining portion of ACL and other tissues in the knee joint. Aim 1 will assess how sex and age impact regional stresses experienced in the AM and PL bundles of the ACL under applied loads. Aim 2 will assess how regional stresses change as an immediate effect of partial injury. Aim 3 will assess how long-term changes in tissue and knee joint mechanics after partial ACL injury impact growth and remodeling of the remainder of the ACL and surrounding cartilage. These aims will be accomplished by developing experimentally validated subject-specific FE models to simulate mechanical loading of the ACL in males and females at different stages of skeletal growth. Additionally, the long- term impact of partial ACL injury will be investigated in vivo using the porcine model. Growth and remodeling will be studied non-invasively using quantitative imaging techniques and computational simulations of growth in response to regional tissue stresses.

项目摘要 小儿前交叉韧带（ACL）损伤和手术干预率在招募中迅速增加 多年。 手术重新构成后的继发性ACL损伤。 在青春期内经历ACL损伤的风险更高，但没有童年或成年。 ACL损伤的机制，并在本质的躯体年龄和性别赛中。 这部分是由于差异实验观察到ACL在有关的过程中的数据和有限的数据 ACL的功能及其前内侧（AM）和后（PL）捆绑骨骼生长。 当韧带经历较高的局部压力 - 集中在小面积上时，可能会造成伤害。 我们小组的初步数据显示了AM和Plus的性别依赖性增长和功能SOT 性年龄似乎可能会影响ACL中局部应力的大小和位置。 该提案的目的是确定年龄和性别如何影响ACL的局部压力 骨骼生长以及部分ACL损伤如何影响ACL剩余部分的生长和重塑 膝关节中的其他组织将评估性别年龄如何影响监管压力 ACL的AM和PL捆绑在施加的载荷下。 AIM 3的IMEDIATE效应将评估组织和膝关节力学的长期变化 在部分ACL损伤后，ACL的补救膜和软骨的疗法重塑。 这些目标将通过开发实验验证的主题特定特定的FE模型来实现。 在骨骼生长的不同阶段，ACL的机械载荷。 部分ACL损伤的期限影响将在体内使用猪模型研究。 使用定量成像技术和计算模拟在非侵入性研究中进行研究 对区域组织应力的抗辩。