Quantitative MRI and Gait Analysis for ACL-Injured and Reconstructed Knees

ACL 损伤和重建膝盖的定量 MRI 和步态分析

• 批准号: 8915484
• 负责人: Xiaojuan Li
• 金额: $ 24.65万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8915484
• 关键词: 3-Dimensional; Acute; Adolescent; Age; Anterior; Anterior Cruciate Ligament; Bilateral; Biochemical; Biomechanics; Cartilage; Cartilage Matrix; Clinic; Data; Degenerative polyarthritis; Development; Diagnostic radiologic examination; Early Diagnosis; Early Intervention; Epidemic; Evaluation; Gender; Human; Imaging Techniques; Injury; Joints; Kinetics; Knee; Knee joint; Knowledge; Laboratories; Lateral; Lead; Life Style; Limb structure; Longitudinal Studies; Lower Extremity; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Measures; Medial; Meniscus structure of joint; Motion; Operative Surgical Procedures; Outcome; Patients; Performance; Physiological; Population; Process; Research Personnel; Rotation; Running; Staging; Techniques; Testing; Tissues; Translating; Translations; Walking; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; cartilage degradation; experience; follow-up; gait examination; high risk; improved; injured; kinematics; ligament injury; loss of function; muscle strength; quantitative imaging; reconstruction; research clinical testing; soft tissue; young adult

Subjects with anterior cruciate ligament (ACL) injuries have a high risk of developing post-traumatic osteoarthritis (OA) despite ACL reconstruction. With the increasing number of ACL injuries in the adolescent population, we are poised to have an epidemic of young adults with post-traumatic OA and loss of function within the next decade. There is a profound need for early detection of biochemical and biomechanical abnormalities in ACL-injured and reconstructed knees. This ability to diagnose early degeneration will enable early intervention, and will provide guidance and critical evaluation for new surgical or pharmacological therapies. Magnetic resonance (MR) T{1p} and T{2} quantification have been used to detect early cartilage degeneration. However, no studies have yet investigated ACL-injured knees longitudinally using these advanced imaging techniques. Kinematic MRI allows for the determination of 3-D knee joint kinematics, including soft tissues, under specific loading conditions. Motion analysis provides evaluation of kinematics and kinetics of the entire limb during physiologic conditions such as walking, running and jumping. In this proposal, we will integrate these three quantitative measures, from tissue composition to joint kinematics and entire limb function, to longitudinally evaluate the biomechanical and biochemical abnormalities in ACL-injured and reconstructed knees. The central hypothesis is that abnormal kinematics and kinetics of ACL-injured and reconstructed knees, as measured by kinematic MRI and motion analysis, will lead to accelerated cartilage degeneration of the knee joint, as indicated by MRI T{1p} and T{2}. Specifically we aim to 1) investigate longitudinal changes in cartilage matrix in ACL-injured and reconstructed knees as indicated by MRI T{1p} and T{2}; 2) To investigate longitudinal changes in kinematics and kinetics in ACL-injured and reconstructed knees using kinematic MRI and motion analysis; and 3) To investigate interrelationship between knee cartilage degeneration and lower extremity kinematics and kinetics in ACL-injured knees. Bilateral knees of patients with acute ACL-injures will be studied at baseline (within 2-4 weeks post injury and prior to ACL reconstruction), 6-month, 1-year and 3-year post ACL reconstruction. Bilateral knees of age, gender and BMI-matched healthy subjects will be studied as controls. With our extensive experience in quantitative and kinematic MRI, and the availability of motion analysis within the Human Performance and Functional Testing Core, we are equipped to investigate the interaction between biochemical and biomechanical abnormalities of ACL-injured and reconstructed knees. A better understanding of this interaction is critical to advance our mechanistic knowledge of post-traumatic OA development in acutely-injured joints. Correlations between quantitative MRI and motion analysis will facilitate an understanding of the interactions leading to degeneration, and translating these techniques into the clinic will ultimately improve patient management and outcome.

具有前交叉韧带（ACL）受伤的受试者受到创伤后发展的高风险 尽管重建了ACL，但骨关节炎（OA）。随着青少年ACL损伤数量的增加 人口，我们准备患有创伤后OA的年轻人流行和功能丧失 在接下来的十年内。非常需要早期检测生化和生物力学 ACL受伤和重建的膝盖异常。这种诊断早期变性的能力将实现 早期干预，并将为新的手术或药理提供指导和批判性评估 疗法。磁共振（MR）T {1p}和T {2}定量已用于检测早期软骨 退化。但是，尚无研究使用这些研究 高级成像技术。运动学MRI允许测定3膝关节运动学， 包括软组织，在特定的负载条件下。运动分析提供了运动学的评估 在生理条件下（例如步行，跑步和跳跃）的整个肢体动力学。在这个 提案，我们将整合从组织组成到关节运动学和 整个肢体功能，纵向评估ACL受伤的生物力学和生化异常 和重建的膝盖。中心假设是ACL受伤的异常运动学和动力学 通过运动学MRI和运动分析测量的重建膝盖将导致 膝关节的加速软骨变性，如MRI T {1p}和T {2}所示。具体而言，我们的目标是1） 研究ACL受伤和重建的膝盖中软骨基质的纵向变化，如 mri t {1p}和t {2}; 2）研究ACL受伤和动力学的纵向变化 使用运动学MRI和运动分析重建膝盖； 3）调查相互关系 在ACL受伤的膝盖中，膝盖软骨变性与下肢运动学和动力学之间。 将在基线时研究急性ACL受伤患者的双侧膝盖（在受伤后2-4周内 在ACL重建之前），ACL重建后6个月，1年和3年。双侧膝盖 年龄，性别和BMI匹配的健康受试者将被研究为对照。有了我们丰富的经验 定量和运动学MRI，以及人类绩效中运动分析的可用性和 功能测试核心，我们有能力研究生化和 ACL受伤和重建的膝盖的生物力学异常。对此有更好的理解 互动对于提高我们对创伤后OA发展的机械知识至关重要 急性伤害的关节。定量MRI与运动分析之间的相关性将有助于 了解导致退化的相互作用，并将这些技术转化为诊所 最终改善患者的管理和结果。