Multi-faceted Approach Modeling ACL Injury Mechanisms

多方位方法模拟 ACL 损伤机制

• 批准号: 8284418
• 负责人: Timothy E Hewett
• 金额: $ 41.7万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-15 至 2013-09-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8284418
• 关键词: Acute; Address; Anterior; Anterior Cruciate Ligament; Athletic; Biomechanics; Computers; Contusions; Coupled; Data; Degenerative polyarthritis; Development; Diagnosis; Elements; Failure; Female; Health Benefit; Human; Injury; Kinetics; Knee; Knee Osteoarthritis; Knee joint; Lead; Life; Ligaments; Lower Extremity; Magnetic Resonance Imaging; Mechanics; Medial; Methods; Modeling; Motion; Operative Surgical Procedures; Outcome Study; Output; Patients; Pattern; Population; Prevention; Prevention program; Protocols documentation; Public Health; Reaction; Rehabilitation therapy; Relative (related person); Reporting; Risk; Rotation; Sex Characteristics; Simulate; Sports; Stress; Surface; Techniques; Testing; Time; Torque; Translations; Validation; anterior cruciate ligament rupture; articular cartilage; bone; career; clinically significant; collateral ligament; design; disability; effective intervention; high risk; in vivo; injured; injury prevention; insight; joint loading; ligament injury; male; mathematical model; pressure; prevent; programs; prospective; response; restraint; simulation; tool

PROJECT SUMMARY The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee, with female athletes sustaining ACL injuries at a 2-8 fold greater rate compared to male athletes. An ACL injury can be devastating and significantly increases the athlete's risk for osteoarthritis long term. While many advances have been made in terms of surgical and rehabilitation treatments for ACL injured patients, long term outcome studies show that these patients are at a high risk for developing knee osteoarthritis 10-15 years after ACL injury regardless of the treatment. Currently, the mechanism of non-contact ACL injury is not well understood. In order to design successful ACL injury prevention programs and address the high rates of ACL injuries in the female athlete population, a better understanding of the non-contact ACL injury mechanism must be established. Both biomechanical data and video analyses indicate that increased abduction loads in the lower extremities may be associated with increased ACL strain and risk of injury. However, the medial collateral ligament (MCL) is considered to be the primary restraint against abduction stress in the knee joint. Clinicians and biomechanists are unable to explain why ACL ruptures without MCL injuries are significantly more common than combined ACL/MCL injuries. We hypothesize that coupled abduction and anterior knee joint loads near full knee extension will lead to disproportional increases in ACL strain relative to MCL strain and lead to ACL failure loads without concomitant MCL failure loads in female athletes. We propose to use a unique blend of the current methods used to investigate ACL injury mechanisms in order to gain an in depth understanding of knee ligament biomechanics during high knee loading conditions. Specifically, we aim to determine the mechanical responses of the ACL and MCL to loads using cadaveric testing, computer mathematical modeling, and three-dimensional motion analysis. Identifying ACL injury mechanisms may help us develop ACL injury prevention programs that would allow many athletes to receive the health benefits of sports participation and avoid the long term sequelae of disability associated with knee osteoarthritis.

项目摘要 前交叉韧带（ACL）是最常见的韧带之一 膝盖，女运动员以增加2-8倍的速度遭受ACL伤害 与男运动员相比。 ACL损伤可能是毁灭性的，并且显着增加 运动员长期患骨关节炎的风险。尽管已经取得了许多进步 ACL受伤患者的手术和康复治疗条款，长期 结果研究表明，这些患者患膝盖的风险很高 ACL损伤后10 - 15年，无论治疗如何，骨关节炎。目前， 非接触式ACL损伤的机制尚不清楚。为了设计 成功预防ACL伤害计划并解决了ACL伤害的高率 女运动员人数，更好地理解非接触式ACL损伤 必须建立机制。生物力学数据和视频分析表明 下肢的外展负荷增加可能与 增加了ACL应变和受伤的风险。但是，内侧副韧带（MCL）为 被认为是反对膝关节绑架应力的主要约束。 临床医生和生物力学无法解释为什么没有MCL的ACL破裂 损伤比联合ACL/MCL损伤更为常见。我们 假设耦合绑架和膝盖前关节靠近全膝盖 相对于MCL菌株，扩展将导致ACL应变的不良增加，并且 导致ACL衰竭负荷没有女运动员而没有MCL衰竭载荷。我们 建议使用用于研究ACL损伤的当前方法的独特混合物 为了深入了解膝盖韧带生物力学的机制 在高膝盖载荷条件下。具体而言，我们旨在确定机械 ACL和MCL对使用尸体测试，计算机数学的响应 建模和三维运动分析。识别ACL损伤机制 可能会帮助我们制定预防ACL伤害计划，以使许多运动员得以 获得运动参与的健康益处，并避免长期后遗症 与膝盖骨关节炎有关的残疾。