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）损伤和手术干预率正在迅速增加 年。特别关注的是，小儿患者的体验可能性是成人的五倍 手术重建后的继发性ACL损伤。此外，性别在女性中起着伤害率的因素 在青少年期间，与男性相比，ACL受伤的风险更高，但没有童年或成年。然而， ACL损伤的机制以及这些年龄和与性别有关的差异背后的原因尚不清楚。 这部分是由于在受伤期间难以实验观察到ACL的困难以及有关 在整个骨骼生长过程中，ACL及其前内侧（AM）和后（PL）束的功能。 ACL 当韧带经历较高的局部压力时，可能会造成伤害 - 孔集中在小面积上。 我们小组的初步数据显示了AM和PL捆绑包的性别依赖性增长和功能，因此 似乎性别和年龄会影响ACL内部应力的大小和位置。所以， 该提议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 其他时候在膝盖关节中。 AIM 1将评估性别和年龄影响区域压力如何 ACL在施加载荷下的AM和PL捆绑包。 AIM 2将评估区域压力如何变化为 局部受伤的直接作用。 AIM 3将评估组织和膝关节力学的长期变化 部分ACL损伤影响了其余ACL和周围软骨的重塑。 这些目标将通过开发实验验证的特定主题特异性FE模型来实现。 在骨骼生长的不同阶段，ACL在男性和女性中的机械载荷。另外，长期 将使用猪模型在体内研究部分ACL损伤的期限影响。增长和改造将 使用定量成像技术和计算模拟在非侵入性的研究中进行研究 对区域组织应力的反应。