ACL Reconstruction in the Female Athlete: Strength, Knee Mechanics and Outcome

女运动员 ACL 重建：力量、膝关节力学和结果

• 批准号: 7769513
• 负责人: Laura C Schmitt
• 金额: $ 5.13万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7769513
• 关键词: Anterior Cruciate Ligament; Arthritis; Bilateral; Biomechanics; Cartilage; Characteristics; Clinical; Control Groups; Degenerative polyarthritis; Development; Drops; Female; Financial compensation; Flexor; Future; Goals; Guidelines; Humulus; Incidence; Individual; Injury; Intervention; Investigation; Joints; Knee; Knee Osteoarthritis; Knee joint; Leg; Limb structure; Lower Extremity; Measures; Mechanics; Muscle; Muscle Weakness; Operative Surgical Procedures; Outcome; Output; Pain; Pathogenesis; Patients; Performance; Phase; Population; Reaction; Rehabilitation therapy; Research; Residual state; Risk; Role; Self Assessment; Side; Sports; Structure; Testing; Time; anterior cruciate ligament reconstruction; arthropathies; articular cartilage; base; cohort; disability; evidence based guidelines; functional outcomes; high risk; indexing; joint injury; ligament injury; male; neuromuscular; quadriceps muscle; reconstruction

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is one of the most prevalent joint disorders that often leads to severe disability. Despite the incidence, relatively little is known regarding the pathogenesis of OA although both cellular and biomechanical mechanisms are implicated. Knee OA commonly develops following anterior cruciate ligament (ACL) injury despite surgical reconstruction, particularly in females. The high incidence of ACL injuries in female athletes, combined with the high risk for future joint damage, motivates investigation of mechanisms underlying the development of knee OA in this population. Quadriceps strength deficits are common following ACL reconstruction and persist long after structured rehabilitation and after patients have returned to high-level activities. Quadriceps muscle weakness is associated with altered joint mechanics that may propagate articular cartilage damage. Little information is known regarding the impact of impaired quadriceps strength on joint mechanics during high-level activities or on longitudinal clinical outcomes. It is suspected that if athletes with ACL reconstruction return to high-level activities and expose their knee to substantial forces without normalized quadriceps strength and joint mechanics, the conditions for articular cartilage damage may be initiated and propagated. Appropriate guidelines for safe return to high-level sport activities following ACL reconstruction are not known. Female athletes are a unique subpopulation within those with ACL injury, and several unique characteristics suggest that they may respond to ACL injury and ACL reconstruction differently than males. The Specific Aims of this proposal involve careful, longitudinal examination of the impact of residual quadriceps strength deficits on knee joint mechanics and on functional outcomes in female athletes with ACL reconstruction. This study represents a comprehensive investigation of female athletes following ACL reconstruction and will serve as a necessary step in establishing safe and appropriate rehabilitation guidelines. Knee OA is a progressive joint disease that often leads to severe pain and disability. Individuals with ACL injury have substantial risk of developing knee OA despite ACL reconstruction. This investigation will provide valuable information regarding potential mechanisms involved in the initiation of arthritic joint changes following ACL injury and reconstruction. Information from this study will serve as springboard for future research of specific interventions that may reduce the risk of arthritic joint changes following ACL injury in female athletes.

描述（由申请人提供）：骨关节炎（OA）是通常导致严重残疾的最普遍的关节疾病之一。尽管发生率，但对于OA的发病机理，尽管涉及细胞和生物力学机制，但对OA的发病机理的了解很少。尽管手术重建，尤其是在女性中，但通常在前交叉韧带（ACL）损伤后出现膝盖OA。女运动员ACL受伤的高发病率加上对未来关节损害的高风险，激发了对该人群中膝盖OA发展的机制的调查。 ACL重建后，股四头肌的强度不足很常见，并且在结构化康复后很长时间持续存在，并且患者恢复了高级活动。股四头肌肌肉无力与可能传播关节软骨损伤的关节力学改变有关。关于股四头肌强度受损对高级活动或纵向临床结局的影响的影响很少。据怀疑，如果没有ACL重建的运动员恢复到高级活动，并将其膝盖暴露在没有归一化股四头肌强度和关节力学的情况下，则可以引发和传播关节软骨损伤的条件。未知的ACL重建后，适当的准则，用于安全返回高级运动活动。女运动员是ACL损伤患者的独特亚群，几个独特的特征表明，他们可能对ACL损伤和ACL重建的反应与男性不同。该提案的具体目的是仔细检查残留的股四头肌强度缺陷对膝关节力学的影响以及ACL重建女运动员的功能结果。这项研究代表了对ACL重建后对女运动员的全面研究，并将作为建立安全且适当的康复指南的必要步骤。膝盖OA是一种进行性关节疾病，通常会导致严重的疼痛和残疾。尽管ACL重建，但ACL损伤的人仍会发生膝关节OA的巨大风险。这项调查将提供有关ACL损伤和重建后关节炎启动涉及的潜在机制的有价值的信息。这项研究的信息将作为对特定干预措施的未来研究的跳板，这些干预措施可能会降低女运动员ACL伤害后关节炎关节变化的风险。

项目成果

Passing return-to-sport criteria and landing biomechanics in young athletes following anterior cruciate ligament reconstruction.

• DOI: 10.1002/jor.25110
• 发表时间: 2022-01
• 期刊: JOURNAL OF ORTHOPAEDIC RESEARCH
• 影响因子: 2.8
• 作者: Losciale, Justin M.;Ithurburn, Matthew P.;Paterno, Mark, V;Schmitt, Laura C.
• 通讯作者: Schmitt, Laura C.

Clinical Factors That Predict a Second ACL Injury After ACL Reconstruction and Return to Sport: Preliminary Development of a Clinical Decision Algorithm.

• DOI: 10.1177/2325967117745279
• 发表时间: 2017-12
• 期刊: Orthopaedic journal of sports medicine
• 影响因子: 2.6
• 作者: Paterno MV;Huang B;Thomas S;Hewett TE;Schmitt LC
• 通讯作者: Schmitt LC

Few young athletes meet newly derived age- and activity-relevant functional recovery targets after ACL reconstruction.

很少有年轻运动员在 ACL 重建后能够达到新制定的与年龄和活动相关的功能恢复目标。

• DOI: 10.1007/s00167-021-06769-4
• 发表时间: 2022
• 期刊: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
• 作者: Ithurburn,MatthewP;Barenius,Björn;Thomas,Staci;Paterno,MarkV;Schmitt,LauraC
• 通讯作者: Schmitt,LauraC

Return-to-sport quadriceps strength symmetry impacts 5-year cartilage integrity after anterior cruciate ligament reconstruction: A preliminary analysis.

• DOI: 10.1002/jor.25029
• 发表时间: 2022-01
• 期刊: Journal of orthopaedic research : official publication of the Orthopaedic Research Society
• 作者: Brunst C;Ithurburn MP;Zbojniewicz AM;Paterno MV;Schmitt LC
• 通讯作者: Schmitt LC

Strength Asymmetry and Landing Mechanics at Return to Sport after Anterior Cruciate Ligament Reconstruction.

• DOI: 10.1249/mss.0000000000000560
• 发表时间: 2015-07
• 期刊: Medicine and science in sports and exercise
• 影响因子: 4.1
• 作者: Schmitt LC;Paterno MV;Ford KR;Myer GD;Hewett TE
• 通讯作者: Hewett TE