Hormone Mediated Knee Joint Laxity and Neuromechanics

激素介导的膝关节松弛和神经力学

• 批准号: 7140878
• 负责人: SANDRA JANINE SHULTZ
• 金额: $ 34.56万
• 依托单位: UNIVERSITY OF NORTH CAROLINA GREENSBORO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140878
• 关键词: clinical research; female; injury; joints; knee

DESCRIPTION (provided by applicant): Greater knee laxity has been identified as a predictor of ACL injury risk in females, and there is now sufficient evidence that sex hormones mediate cyclic changes in knee laxity across the menstrual cycle and in large part account for greater knee laxity in females compared to males. Our objective for this proposal is to determine the consequence of both greater absolute baseline anterior knee laxity (ABSAKi.) and cyclic increases in anterior knee laxity (CYCAKi.) on knee joint neuromechanics during functional activities. Our approach will be to recruit males and females with a broad range of baseline knee laxity values, then track females across their menstrual cycle to identify the specific days in their early follicular and luteal phases when knee laxity values are at their minimum and maximum respectively. We will then measure males and females on weight bearing knee joint neuromechanics at these specified time points to examine the independent and combined effects of sex, absolute baseline knee laxity and cyclic increases in knee laxity on knee joint neuromechanics. Our central hypothesises that greater absolute baseline and greater cyclic increases in knee laxity will independently and in combination predict greater anterior tibial translation during the transition from non-weight bearing to weight bearing, and greater "functional valgus collapse" of the knee during a single leg weight bearing perturbation. Our rationale for examining the effects of both greater absolute baseline and cyclic increases in knee laxity on weight bearing knee joint neuromechanics is that the successful completion of this work will advance our understanding of the factors contributing to "at risk" joint positions that are known to strain and injure the ACL. Because we expect that cyclic increases in knee laxity will be a significant predictor of at risk knee joint neuromechanics, we also plan to develop a predictive algorithm that will better enable clinicians and researchers in future prospective studies to reliably identify female hormone responders (those who experience cyclic increases in knee laxity > 3mm) based on several key hormone measures. ACL injury can profoundly impact on health and physical activity, both immediately following injury and reconstructive surgery, and later in life as a consequence of the early onset of osteoarthritis. These complications are of greatest concern in young active females, who are at a 2 to 9 times greater risk of suffering ACL injury compared to equivalently trained males. Advancing our knowledge of the underlying pathophysiological mechanism(s) of ACL injuries will further the development of optimal prevention, rehabilitation and training strategies to reduce the risk of sport-related injury, thereby enhancing the beneficial effects of physical activity on women's health for all ages.

描述（由申请人提供）：膝关节松弛度更大已被确定为女性ACL损伤风险的预测因子，目前有足够的证据表明，性激素介导了月经周期中膝关节松弛度的周期性变化，并且在很大程度上导致女性膝关节松弛度大于男性。我们的目标是确定更大的绝对基线膝前松弛（ABSAKi）的后果。和膝前松弛度（CYCAKi）周期性增加。对膝关节功能活动的神经力学影响。我们的方法是招募具有广泛基线膝关节松弛值的男性和女性，然后在月经周期中跟踪女性，以确定膝关节松弛值分别处于最小值和最大值的早期卵泡和黄体期的特定日期。然后，我们将在这些指定时间点测量男性和女性的负重膝关节神经力学，以检查性别、绝对基线膝关节松弛和膝关节松弛周期性增加对膝关节神经力学的独立和综合影响。我们的中心假设是，膝关节松弛度的绝对基线值越大和周期性增加越大，将独立和联合预测从非承重到承重的过渡期间胫骨前平移越大，以及单腿承重扰动期间膝关节“功能性外翻塌陷”越大。我们检查膝关节松弛度的更大绝对基线和周期性增加对负重膝关节神经力学的影响的理由是，这项工作的成功完成将促进我们对已知会使ACL应变和损伤的“危险”关节位置的因素的理解。由于我们预计膝关节松弛度的周期性增加将是膝关节神经力学风险的重要预测因素，因此我们还计划开发一种预测算法，该算法将更好地使临床医生和研究人员在未来的前瞻性研究中能够基于几种关键激素指标可靠地识别女性激素应答者（膝关节松弛度周期性增加> 3mm的人）。ACL损伤会对健康和身体活动产生深远的影响，无论是在损伤和重建手术后，还是在以后的生活中，都是骨关节炎早期发作的结果。这些并发症在年轻活跃女性中最受关注，与同等训练的男性相比，她们遭受ACL损伤的风险高2至9倍。提高我们对ACL损伤的潜在病理生理机制的认识，将进一步发展最佳的预防、康复和训练策略，以降低运动相关损伤的风险，从而增强体育活动对所有年龄段女性健康的有益影响。