Factors influencing the evolution of knee osteoarthritis

描述（由申请人提供）： 该职业发展奖的目标是通过正式的课程工作计划扩展候选人在临床研究方面的基础知识，帮助候选人融入学术研究社区，并提供成功开发未来独立临床研究所需的经验和知识。本研究的目的是评估参与特发性骨关节炎（OA）发病机制的早期因素。异常动态关节负荷、肌肉无力和本体感觉缺陷已被独立研究，并与OA相关。文献表明，这些因素可能是相互关联的，但是，没有一项研究着眼于这些因素在OA的发病机制。根据候选人的近期研究结果选择研究人群：患有晚期单侧髋关节OA的受试者更常发生对侧膝关节OA而非同侧膝关节OA，并且这些受试者在髋关节置换术前后对侧膝关节的动态关节负荷高于同侧膝关节。这是对45例症状性早期单侧髋关节OA和45例终末期单侧髋关节OA受试者的膝关节进行的横断面评价。具体的目的是调查负载，肌肉力量和膝关节本体感觉之间的关系，以确定这些因素之间的不对称性同侧和对侧膝关节，并评估这些因素在早期和晚期的单侧髋关节OA。受试者将接受访谈、体格检查和X线摄影。专门的测试将包括双X射线吸收测量法、步态分析、本体感觉评估和双膝肌力测试。将对数据进行评价，以评估因素之间的特定关联，评估受试者膝关节之间因素的不对称性，并证明单侧髋关节OA的早期和晚期是否存在类似的不对称性。这项研究的结果可以显着影响我们的神经力学机制的OA发病机制的理解，并可能提供新的途径，治疗，也许在OA的一级预防干预。

DESCRIPTION (provided by applicant): The goals of this career development award are to expand the candidate's fundamental knowledge in clinical research through a formal course work program, help integrate the candidate into the academic research community, and to provide the experience and knowledge she will need to successfully develop future independent clinical investigations. This study's purpose is to evaluate early factors involved in the etiopathogenesis of idiopathic osteoarthritis (OA). Abnormal dynamic joint loading, muscle weakness, and proprioception deficits have been independently studied and linked to OA. The literature suggests that these factors may be interrelated; however, no single study has looked at these factors together in the pathogenesis of OA. The study population is chosen based upon the candidate's recent investigational findings: that subjects with advanced unilateral hip OA more commonly develop OA of the contralateral knee rather than the ipsilateral knee and that these subjects have higher dynamic joint loads at the contralateral knee relative to the ipsilateral knee before and after hip replacement. This is a cross-sectional evaluation of the knees of 45 subjects with symptomatic early unilateral hip OA and 45 subjects with endstage unilateral hip OA. The specific aims are to investigate relationships between loading, muscle strength, and proprioception of the knees, to identify asymmetries in these factors between the ipsilateral and contralateral knees, and to evaluate these factors in both early and endstages of unilateral hip OA. Subjects will undergo interview, physical exam, and radiography. Specialized testing will include dual x-ray absorptiometry, gait analysis, proprioception evaluation and muscle strength testing of both knees. The data will be evaluated to assess specific associations between the factors, to assess asymmetries in the factors between the subjects' knees, and to demonstrate whether similar asymmetries are present in both early and endstages of unilateral hip OA. The results from this investigation can significantly impact our understanding of neuromechanical mechanisms in the pathogenesis of OA and may provide new avenues for therapeutic and perhaps primary prevention intervention in OA.