Multi-faceted Approach Modeling ACL Injury Mechanisms

项目总结 前十字韧带(ACL)是膝关节最常见的损伤韧带之一。 膝盖，女运动员遭受前交叉韧带损伤的几率要高出2-8倍 与男性运动员相比。前交叉韧带损伤可能是毁灭性的，并显著增加 从长远来看，运动员患骨关节炎的风险。虽然在这方面取得了许多进展 前交叉韧带损伤患者的长期手术和康复治疗条件 结果研究表明，这些患者患膝关节疾病的风险很高。 前交叉韧带损伤后10-15年的骨性关节炎，无论采用何种治疗。目前， 非接触性前交叉韧带损伤的机制尚不清楚。为了设计 成功的前交叉韧带损伤预防计划和解决前交叉韧带损伤的高比率 女性运动员群体对非接触性前交叉韧带损伤的认识 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 增加了前交叉韧带的拉伤和受伤风险。然而，内侧副韧带(MCL) 被认为是对膝关节外展应力的主要约束。 临床医生和生物机械师无法解释为什么在没有MCL的情况下前交叉韧带断裂 损伤明显比ACL/MCL联合损伤更常见。我们 假设外展和膝关节前关节负荷接近全膝关节 伸展将导致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前交叉韧带失效载荷，但没有伴随的单交叉韧带失效载荷。我们 建议使用目前用于调查前交叉韧带损伤的独特方法的混合 为深入了解膝关节韧带的生物力学机制 在高膝部负荷条件下。具体地说，我们的目标是确定机械 用身体测试、计算机数学方法测量前交叉韧带和上肢前交叉韧带对载荷的反应 建模和三维运动分析。确定前交叉韧带损伤机制 可以帮助我们开发前交叉韧带损伤预防计划，使许多运动员能够 获得运动参与的健康益处，避免长期的后遗症 与膝骨性关节炎相关的残疾。

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.