Multi-faceted Approach Modeling ACL Injury Mechanisms

多方位方法模拟 ACL 损伤机制

• 批准号: 8069179
• 负责人: Timothy E Hewett
• 金额: $ 43.11万
• 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 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8069179
• 关键词: Acute; Address; Anterior; Anterior Cruciate Ligament; Athletic; Biomechanics; Computers; Contusions; Coupled; Data; Degenerative polyarthritis; Development; Diagnosis; Elements; Failure; Female; Health; 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

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: An anterior cruciate ligament (ACL) injury can be devastating and places an athlete at a high risk of developing osteoarthritis long term. Unfortunately, surgical intervention does not change the odds of developing knee osteoarthritis after injury. We utilize biomechanical methods to identify mechanisms of ACL injury in order to develop effective interventions to prevent ACL injury.

描述（申请人提供）：前十字韧带 (ACL) 是膝关节最常见损伤的韧带之一，女性运动员 ACL 损伤的发生率是男性运动员的 2-8 倍。 ACL 损伤可能是毁灭性的，并且会显着增加运动员长期患骨关节炎的风险。尽管在 ACL 损伤患者的手术和康复治疗方面取得了许多进展，但长期结果研究表明，无论采取何种治疗方式，这些患者在 ACL 损伤后 10-15 年内发生膝骨关节炎的风险很高。目前，非接触性 ACL 损伤的机制尚不清楚。为了设计成功的 ACL 损伤预防方案并解决女运动员群体中 ACL 损伤的高发生率，必须更好地了解非接触性 ACL 损伤机制。生物力学数据和视频分析表明，下肢外展负荷的增加可能与 ACL 应变和受伤风险的增加有关。然而，内侧副韧带（MCL）被认为是膝关节外展应力的主要约束因素。临床医生和生物力学学家无法解释为什么没有 MCL 损伤的 ACL 断裂比 ACL/MCL 联合损伤更常见。我们假设，在女性运动员中，在膝关节完全伸展时，外展和膝关节前部联合载荷将导致 ACL 应变相对于 MCL 应变不成比例地增加，并导致 ACL 失效载荷，而不会伴随 MCL 失效载荷。我们建议使用当前用于研究 ACL 损伤机制的方法的独特组合，以便深入了解膝关节高负荷条件下的膝关节韧带生物力学。具体来说，我们的目标是使用尸体测试、计算机数学建模和三维运动分析来确定 ACL 和 MCL 对负载的机械响应。确定 ACL 损伤机制可能有助于我们制定 ACL 损伤预防计划，使许多运动员能够从参与运动中获得健康益处，并避免与膝骨关节炎相关的残疾的长期后遗症。公众健康相关性：前十字韧带 (ACL) 损伤可能是毁灭性的，使运动员长期处于患骨关节炎的高风险中。不幸的是，手术干预并不能改变受伤后发生膝骨关节炎的几率。我们利用生物力学方法来确定 ACL 损伤的机制，以便制定有效的干预措施来预防 ACL 损伤。