Multi-faceted Approach Modeling ACL Injury Mechanisms

多方位方法模拟 ACL 损伤机制

• 批准号: 8284418
• 负责人: Timothy E Hewett
• 金额: $ 41.7万
• 依托单位: OHIO STATE UNIVERSITY
• 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 2013-09-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8284418
• 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; joint loading; ligament injury; male; mathematical model; pressure; prevent; programs; prospective; response; restraint; simulation; tool

PROJECT SUMMARY 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.

项目摘要 前交叉韧带（ACL）是膝关节最常见的损伤韧带之一， 膝关节，女性运动员的ACL损伤率是男性的2-8倍 与男性运动员相比。ACL损伤可能是毁灭性的， 运动员患骨关节炎的风险。虽然已经取得了许多进展， ACL损伤患者的手术和康复治疗，长期 结果研究表明，这些患者患膝关节炎的风险很高， ACL损伤后10-15年的骨关节炎，无论治疗如何。目前 非接触性ACL损伤的机制还不清楚。为了设计 成功的ACL损伤预防计划，并解决ACL损伤的高发生率， 女性运动员人群，更好地了解非接触性ACL损伤 必须建立机制。生物力学数据和视频分析都表明 下肢外展负荷增加可能与 增加ACL应变和受伤的风险。内侧副韧带（MCL） 被认为是对膝关节外展应力的主要限制。 临床医生和生物力学家无法解释为什么ACL在没有MCL的情况下断裂 损伤明显比ACL/MCL联合损伤更常见。我们 假设在全膝关节附近耦合外展和前膝关节载荷 延伸将导致ACL应变相对于MCL应变不成比例地增加， 导致女性运动员ACL失效载荷而没有伴随MCL失效载荷。我们 我建议使用目前用于研究ACL损伤的独特方法 为了深入了解膝关节韧带的生物力学机制， 在高膝关节负荷条件下。具体来说，我们的目标是确定机械 ACL和MCL对载荷的响应，采用尸体测试，计算机数学 建模和三维运动分析。识别ACL损伤机制 可以帮助我们制定ACL损伤预防计划，使许多运动员能够 享受运动带来的健康益处，避免运动带来的长期后遗症 与膝关节骨关节炎相关的残疾。