Laxity and Malalignment in a Large Cohort Study of OA

OA 大型队列研究中的松弛和排列不齐

• 批准号: 6948788
• 负责人: MICHAEL C NEVITT
• 金额: $ 6.21万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-26 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6948788
• 关键词: biomechanics; clinical research; disease /disorder proneness /risk; human middle age (35-64); human old age (65+); human subject; knee; magnetic resonance imaging; musculoskeletal imaging /visualization /scanning; osteoarthritis; patient oriented research; radiography

DESCRIPTION (provided by applicant): Knee OA is a leading cause of chronic disability in older Americans. Few strategies to prevent knee OA development, progression, or disability exist, due to limited knowledge of the responsible factors. There has been increasing recognition of the role of knee laxity and malalignment, two potentially modifiable factors that are the focus of the current application. These factors are being examined in the ongoing 300-subject MAK study (Mechanical Factors in Arthritis of the Knee) at Northwestern University, in which extensive experience has been gained with them, and evidence of their importance has accumulated. Now proposed is a comprehensive examination of the effect of laxity and malalignment in subjects with or at high risk to develop knee OA, as an ancillary study to the recently funded Multicenter OA Study (MOST). MOST is a study of 3000 men and women, with the primary goal of examining the effect of a panel of risk factors on OA outcomes over 3 years. MOST involves 4 sites: the Coordinating and MRI Reading Center (UCSF), Data Analysis and X-ray Reading Center (BU), and 2 Clinical Centers (UAB and UI). Hypotheses of this application focus on whether laxity and malalignment are each associated with: a higher risk of incident OA than non-lax knees and more neutrally aligned knees; a decline in physical function; risk of OA progression. Primary hypotheses focus on symptom and x-ray outcomes; MRI-based assessment of cartilage morphology is also proposed as a means of examining the compartment-specific effects of each of these factors in a subset of the MOST cohort. Support is requested: to replicate in MOST the measurement systems and protocols (for laxity and alignment) currently in use in the MAK study; to assess laxity and alignment at the baseline exam of MOST; in a subset of the cohort, to obtain MRI at baseline and at 3 year follow-up using a high-field scanner to examine change in cartilage volume and thickness as outcomes of laxity and malalignment; and to test the relationship of laxity and malalignment with risk of important OA outcomes.

描述（由申请人提供）：膝盖OA是老年人慢性残疾的主要原因。由于对负责任因素的了解有限，很少有防止膝盖OA发育，进展或残疾的策略。人们对膝关节松弛和失误的作用的认识越来越多，这是当前应用的两个潜在可修改因素。西北大学正在进行的300个受试者MAK研究（膝盖关节炎的机械因素）正在研究这些因素，其中已经获得了丰富的经验，并且积累了其重要性的证据。 现在提出的是对患有或高风险发育膝关节OA的受试者的松弛和恶意作用的全面检查，作为对最近资助的多中心OA研究（大多数）的辅助研究（大多数）。大多数是对3000名男性和女性的研究，其主要目的是检查危险因素对3年以来OA结果的影响。大多数涉及4个站点：协调和MRI阅读中心（UCSF），数据分析和X射线阅读中心（BU）和2个临床中心（UAB和UI）。 该应用的假设集中于宽松和恶意是否与以下方式相关：与非乳头膝盖相比，OA发生的风险更高，膝盖更中性统一；身体机能下降； OA进展的风险。主要假设着眼于症状和X射线预后；还提出了基于MRI的软骨形态评估，作为在最大的一部分中检查每个因素的隔室特异性效应的一种手段。 请求支持：在MAK研究中目前正在使用的大多数测量系统和协议（用于松弛和一致性）中复制；在大多数基线考试中评估宽松和一致性；在队列的一部分中，使用高场扫描仪在基线和3年随访中获得MRI，以检查软骨体积和厚度的变化，作为松弛和失误的结果；并测试松弛和不满的关系与重要OA结果的风险。