Multi-faceted Approach Modeling ACL Injury Mechanisms

多方位方法模拟 ACL 损伤机制

• 批准号: 7654283
• 负责人: Timothy E Hewett
• 金额: $ 62.8万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 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/7654283
• 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; ligament injury; male; mathematical model; pressure; prevent; programs; prospective; public health relevance; 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（由申请人提供）：前交叉韧带（ACL）是膝盖最常见受伤的韧带之一，与男运动员相比，女运动员以2-8倍的速度承受ACL损伤。 ACL损伤可能是毁灭性的，并显着增加了运动员长期骨关节炎的风险。尽管已在ACL受伤患者的手术和康复治疗方面取得了许多进展，但长期结局研究表明，这些患者在ACL损伤后10 - 15年患有高风险患膝关节骨关节炎。当前，非接触式ACL损伤的机制尚不清楚。为了设计成功的ACL伤害预防计划并解决女运动员人群中ACL损伤的高率，必须更好地了解非接触式ACL损伤机制。生物力学数据和视频分析都表明，下肢的外展负荷增加可能与ACL应变和受伤风险增加有关。但是，内侧副韧带（MCL）被认为是针对膝关节外展应力的主要限制。临床医生和生物力学者无法解释为什么没有MCL损伤的ACL破裂比联合ACL/MCL损伤更为普遍。我们假设，相对于MCL菌株，ACL菌株的耦合外展和前膝关节载荷在全膝关节伸展附近会导致不成比例的增加，并导致ACL衰竭载荷，而女性运动员的MCL失败负荷也会导致ACL衰竭载荷。我们建议使用用于研究ACL损伤机制的当前方法的独特混合物，以便深入了解高膝关节荷载条件下的膝盖韧带生物力学。具体而言，我们旨在确定使用尸体测试，计算机数学建模和三维运动分析的ACL和MCL对负载的机械响应。识别ACL损伤机制可能有助于我们制定ACL损伤预防计划，这些计划将使许多运动员能够获得运动参与的健康益处，并避免与膝盖骨关节炎相关的残疾后遗症。公共卫生相关性：前交叉韧带（ACL）损伤可能是毁灭性的，并使运动员长期患有骨关节炎的高风险。不幸的是，手术干预不会改变受伤后膝关节骨关节炎的几率。我们利用生物力学方法来识别ACL损伤的机制，以制定有效的干预措施以防止ACL损伤。