Effect of Age, Sex, and Injury on Regional Stresses and Resulting Growth of the Anterior Cruciate Ligament

年龄、性别和损伤对区域应力及其导致的前十字韧带生长的影响

• 批准号: 10407971
• 负责人: Danielle Howe
• 金额: $ 1.56万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2022-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10407971
• 关键词: Adolescence; Adolescent; Adult; Affect; Age; Animals; Anterior Cruciate Ligament; Area; Biological; Biomechanics; Cartilage; Child; Childhood; Clinical Treatment; Collagen; Computer Models; Computer Simulation; Computing Methodologies; Consensus; Data; Diagnosis; Elements; Family suidae; Female; GAG Gene; Geometry; Goals; Growth; Image; Imaging Techniques; Injury; Joints; Knee; Knee joint; Ligaments; Location; Long-Term Effects; Magnetic Resonance Imaging; Measures; Mechanics; Modeling; Modulus; Operative Surgical Procedures; Orthopedics; Outcome Study; Patients; Pattern; Play; Preventive measure; Property; Quality of life; Reconstructive Surgical Procedures; Research; Research Personnel; Robotics; Sex Differences; Specimen; Stifle joint; Stress; Techniques; Testing; Time; Tissues; Training; Youth; age effect; anterior cruciate ligament injury; base; experience; high risk; improved; in vivo; injured; kinematics; ligament injury; male; mechanical load; mechanical stimulus; pediatric patients; porcine model; quantitative imaging; reconstruction; response; sex; simulation; skeletal; tissue stress; treatment strategy; trend

PROJECT SUMMARY Pediatric anterior cruciate ligament (ACL) injuries and surgical intervention rates are rapidly increasing in recent years. Of particular concern, pediatric patients are approximately five times more likely than adults to experience a secondary ACL injury after surgical reconstruction. Further, sex plays a factor in injury rates, where females experience a higher risk of ACL injury than males during adolescence, but not childhood or adulthood. However, the mechanism of ACL injuries and the reasons behind these age and sex-related differences remain unclear. This is, in part, due to difficulty experimentally observing the ACL during injury and limited data regarding the function of the ACL and its anteromedial (AM) and posterolateral (PL) bundles throughout skeletal growth. ACL injuries likely occur when the ligament experiences high local stresses—forces concentrated over a small area. Preliminary data from our group has shown sex-dependent growth and function of the AM and PL bundles, so it seems likely that sex and age will impact the magnitude and location of local stresses within the ACL. Therefore, the objective of this proposal is to determine how age and sex impact local stresses in the ACL throughout skeletal growth and how partial ACL injury may affect growth and remodeling of the remaining portion of ACL and other tissues in the knee joint. Aim 1 will assess how sex and age impact regional stresses experienced in the AM and PL bundles of the ACL under applied loads. Aim 2 will assess how regional stresses change as an immediate effect of partial injury. Aim 3 will assess how long-term changes in tissue and knee joint mechanics after partial ACL injury impact growth and remodeling of the remainder of the ACL and surrounding cartilage. These aims will be accomplished by developing experimentally validated subject-specific FE models to simulate mechanical loading of the ACL in males and females at different stages of skeletal growth. Additionally, the long- term impact of partial ACL injury will be investigated in vivo using the porcine model. Growth and remodeling will be studied non-invasively using quantitative imaging techniques and computational simulations of growth in response to regional tissue stresses.

项目摘要 近年来，儿童前交叉韧带（ACL）损伤和手术干预率迅速增加 年特别值得关注的是，儿童患者发生这种情况的可能性是成人患者的五倍。 手术重建后继发ACL损伤此外，性别在受伤率中起着重要作用， 在青春期，ACL损伤的风险高于男性，但在儿童期或成年期则不然。然而，在这方面， ACL损伤的机制以及这些年龄和性别相关差异背后的原因仍不清楚。 这部分是由于在损伤过程中难以通过实验观察ACL，以及关于ACL损伤的数据有限。 ACL及其前内侧（AM）和后外侧（PL）束在整个骨骼生长过程中的功能。ACL 当韧带经受高的局部应力-集中在小区域上的力时，可能发生损伤。 我们小组的初步数据显示，AM和PL束的生长和功能具有性别依赖性，因此， 性别和年龄似乎会影响ACL内局部应力的大小和位置。因此，我们认为， 本建议的目的是确定年龄和性别如何影响ACL的局部应力 骨骼生长以及部分ACL损伤如何影响ACL其余部分的生长和重塑 以及膝关节内的其他组织。目标1将评估性别和年龄如何影响地区经历的压力 在施加载荷下ACL的AM和PL束。目标2将评估区域应力如何变化， 局部损伤的直接影响。目标3将评估组织和膝关节力学的长期变化 在部分ACL损伤后，影响ACL剩余部分和周围软骨的生长和重塑。 这些目标将通过开发实验验证的特定主题的有限元模型来模拟 在骨骼生长的不同阶段，男性和女性ACL的机械负荷。此外，长- 将使用猪模型在体内研究部分ACL损伤的长期影响。增长和重塑将 使用定量成像技术和生长的计算模拟进行非侵入性研究， 对局部组织应力的反应。