Prospective study of biomechanics and early degeneration after ACL reconstruction

ACL 重建后生物力学和早期退变的前瞻性研究

• 批准号: 8878028
• 负责人: Laura C Schmitt
• 金额: $ 16.1万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-23 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8878028
• 关键词: Activities of Daily Living; Adolescent and Young Adult; Adult; Age; American; Anterior Cruciate Ligament; Area; Athletic Injuries; Bilateral; Biomechanics; Cartilage; Characteristics; Clinical; Clinical Data; Complex; Contralateral; Data; Degenerative polyarthritis; Development; Enrollment; Frequencies; Gait; Goals; Health Care Costs; High Prevalence; Image; Individual; Injury; Joints; Kinetics; Knee; Knee Osteoarthritis; Knowledge; Limb structure; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Motion; Operative Surgical Procedures; Outcome; Pain; Pathogenesis; Pattern; Population; Positioning Attribute; Predictive Value; Procedures; Process; Prospective Studies; Quality of life; Recruitment Activity; Rehabilitation therapy; Relative (related person); Relaxation; Risk; Role; Shock; Testing; Time; Work; absorption; anterior cruciate ligament reconstruction; arthropathies; articular cartilage; base; cartilage degradation; cohort; cost; disability; follow-up; functional decline; functional disability; high risk; improved; interest; joint loading; kinematics; knee mechanics; ligament injury; middle age; premature; prevent; prospective; public health relevance; reconstruction; rho

DESCRIPTION (provided by applicant): Premature development of knee osteoarthritis (OA) is recognized with increasing frequency following anterior cruciate ligament (ACL) injuries. ACL injury is one of the most common and debilitating athletic injuries in adolescents and young adults with a majority requiring an ACL reconstruction procedure. As early as 7-15 years following reconstruction, a large majority of individuals develop knee OA, a major cause of pain, functional disability and decline in quality of life throughout the adult life-span. The developmen of knee OA is a complex process resulting from multiple factors of which altered knee kinematics and kinetics are known contributors. Altered knee kinematics and kinetics are observed following ACL reconstruction during activities of daily living as well as during high-leve activities, and persist for as long as two years following ACL reconstruction. Our overall study objective is to investigate the role of knee kinematics and kinematics following ACL reconstruction on articular cartilage integrity and knee mechanics 5 years later. The first Aim wil determine if knee mechanics at post-ACL reconstruction are stable and track to 5 years later. The second Aim will determine if post-ACL reconstruction knee mechanics predict measures of cartilage integrity at 5 years following ACL reconstruction. For this study, we will utilize biomechanical and clinical data from 30 individuals that we previously collected following primary, unilateral ACL reconstruction. We will extend our previously collected data with magnetic resonance imaging and biomechanical data at 5 years post-ACL reconstruction in the same cohort. Three-dimensional knee kinematics and kinetics will quantify knee mechanics and 3-T MR imaging will be used to quantify morphological and compositional (T1-rho and T2 relaxation time) characteristics of knee articular cartilage. This approach will allow for immediat testing of our overall hypothesis that post-ACL reconstruction knee mechanics persist at 5 years later and are associated with measures of articular cartilage integrity. Through this proposal, we will establish the potential role of post-ACL reconstruction mechanics on early cartilage degeneration, advancing fundamental knowledge of the early pathogenesis of knee OA. Successful completion of this study will allow for the development and testing of rehabilitation and surgical treatment options for individuals with ACL injury that may better restore knee mechanics, and ultimately may mitigate development of premature OA.

描述（由申请人提供）：膝关节骨关节炎（OA）的过早发育在前交叉韧带（ACL）损伤后频率增加。 ACL损伤是青少年和年轻人中最常见和令人衰弱的运动损伤之一，其中大多数需要ACL重建程序。重建后的7 - 15年，大多数人会出现膝盖OA，这是整个成人寿命的疼痛，功能残疾和生活质量下降的主要原因。膝关节OA的发育人物是一个复杂的过程，其多种因素导致了膝关节运动和动力学的改变是已知的贡献者。 ACL重建后，在日常生活和高级活动期间，ACL重建后观察到膝关节运动和动力学的改变，并且在ACL重建后长达两年。我们的总体研究目标是研究ACL重建后膝关节运动学和运动学对关节软骨完整性和膝盖力学的作用。第一个目标将确定ACL后重建的膝盖力学是否稳定，并在5年后轨迹。第二个目标将确定ACL后膝盖力学后5年后5年的软骨完整性测量是否预测了软骨完整性的度量。在这项研究中，我们将利用来自先前单侧ACL重建后先前收集的30个个体的生物力学和临床数据。我们将在同一队列的ACL重建后5年使用磁共振成像和生物力学数据扩展先前收集的数据。三维膝关节运动学和动力学将量化膝盖力学，3-T MR成像将用于量化膝关节软骨的形态学和组成（T1-RHO和T2松弛时间）特征。这种方法将立即测试我们的总体假设，即5年后，ACL重建后的膝盖力学持续存在，并与关节软骨完整性的度量有关。通过这项建议，我们将确定ACL后重建力学对早期软骨变性的潜在作用，从而促进对膝关节早期发病机理的基本知识。这项研究的成功完成将允许为ACL损伤患者的康复和手术治疗方案开发和测试，这可能更好地恢复膝盖力学，并最终可能减轻过早OA的发展。