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.

项目概要 前十字韧带（ACL）是最常见损伤的韧带之一 膝盖，女性运动员 ACL 受伤的几率是女性运动员的 2-8 倍 与男运动员相比。 ACL 损伤可能是毁灭性的，并且会显着增加 运动员长期患骨关节炎的风险。虽然已经取得了许多进步 ACL 损伤患者的长期手术和康复治疗 结果研究表明这些患者患膝关节的风险很高 无论接受何种治疗，ACL 损伤后 10-15 年都会出现骨关节炎。目前， 非接触性 ACL 损伤的机制尚不清楚。为了设计 成功的 ACL 损伤预防计划并解决了 ACL 损伤的高发生率 女性运动员群体，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 下肢外展负荷的增加可能与 增加 ACL 应变和受伤风险。然而，内侧副韧带（MCL） 被认为是膝关节外展应力的主要约束。 临床医生和生物力学学家无法解释为什么 ACL 会在没有 MCL 的情况下破裂 损伤比 ACL/MCL 联合损伤更为常见。我们 假设在全膝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，并且 导致女性运动员出现 ACL 失效负荷，但没有伴随 MCL 失效负荷。我们 建议使用当前用于研究 ACL 损伤的方法的独特组合 机制，以便深入了解膝关节韧带生物力学 在膝关节高负荷条件下。具体来说，我们的目标是确定机械 使用尸体测试、计算机数学来评估 ACL 和 MCL 对负载的响应 建模和三维运动分析。识别 ACL 损伤机制 可能会帮助我们制定 ACL 损伤预防计划，使许多运动员能够 获得参加体育运动的健康益处并避免长期后遗症 与膝骨关节炎相关的残疾。