Prospective study of biomechanics and early degeneration after ACL reconstruction

ACL 重建后生物力学和早期退变的前瞻性研究

• 批准号: 8878028
• 负责人: Laura C Schmitt
• 金额: $ 16.1万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-23 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8878028
• 关键词: Activities of Daily Living; Adolescent and Young Adult; Adult; Age; American; Anterior Cruciate Ligament; Area; Athletic Injuries; Bilateral; Biomechanics; Cartilage; Characteristics; Clinical; Clinical Data; Complex; Contralateral; Data; Degenerative polyarthritis; Development; Enrollment; Frequencies; Gait; Goals; Health Care Costs; High Prevalence; Image; Individual; Injury; Joints; Kinetics; Knee; Knee Osteoarthritis; Knowledge; Limb structure; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Motion; Operative Surgical Procedures; Outcome; Pain; Pathogenesis; Pattern; Population; Positioning Attribute; Predictive Value; Procedures; Process; Prospective Studies; Quality of life; Recruitment Activity; Rehabilitation therapy; Relative (related person); Relaxation; Risk; Role; Shock; Testing; Time; Work; absorption; anterior cruciate ligament reconstruction; arthropathies; articular cartilage; base; cartilage degradation; cohort; cost; disability; follow-up; functional decline; functional disability; high risk; improved; interest; joint loading; kinematics; knee mechanics; ligament injury; middle age; premature; prevent; prospective; public health relevance; reconstruction; rho

DESCRIPTION (provided by applicant): Premature development of knee osteoarthritis (OA) is recognized with increasing frequency following anterior cruciate ligament (ACL) injuries. ACL injury is one of the most common and debilitating athletic injuries in adolescents and young adults with a majority requiring an ACL reconstruction procedure. As early as 7-15 years following reconstruction, a large majority of individuals develop knee OA, a major cause of pain, functional disability and decline in quality of life throughout the adult life-span. The developmen of knee OA is a complex process resulting from multiple factors of which altered knee kinematics and kinetics are known contributors. Altered knee kinematics and kinetics are observed following ACL reconstruction during activities of daily living as well as during high-leve activities, and persist for as long as two years following ACL reconstruction. Our overall study objective is to investigate the role of knee kinematics and kinematics following ACL reconstruction on articular cartilage integrity and knee mechanics 5 years later. The first Aim wil determine if knee mechanics at post-ACL reconstruction are stable and track to 5 years later. The second Aim will determine if post-ACL reconstruction knee mechanics predict measures of cartilage integrity at 5 years following ACL reconstruction. For this study, we will utilize biomechanical and clinical data from 30 individuals that we previously collected following primary, unilateral ACL reconstruction. We will extend our previously collected data with magnetic resonance imaging and biomechanical data at 5 years post-ACL reconstruction in the same cohort. Three-dimensional knee kinematics and kinetics will quantify knee mechanics and 3-T MR imaging will be used to quantify morphological and compositional (T1-rho and T2 relaxation time) characteristics of knee articular cartilage. This approach will allow for immediat testing of our overall hypothesis that post-ACL reconstruction knee mechanics persist at 5 years later and are associated with measures of articular cartilage integrity. Through this proposal, we will establish the potential role of post-ACL reconstruction mechanics on early cartilage degeneration, advancing fundamental knowledge of the early pathogenesis of knee OA. Successful completion of this study will allow for the development and testing of rehabilitation and surgical treatment options for individuals with ACL injury that may better restore knee mechanics, and ultimately may mitigate development of premature OA.

描述（由申请人提供）：前交叉韧带（ACL）损伤后，膝关节骨关节炎（OA）的过早发生率越来越高。ACL损伤是青少年和年轻人中最常见和最令人衰弱的运动损伤之一，大多数需要ACL重建手术。早在重建后的7-15年，绝大多数个体发展为膝关节OA，这是整个成人寿命期间疼痛、功能残疾和生活质量下降的主要原因。膝关节OA的发生是一个复杂的过程，由多种因素引起，其中膝关节运动学和动力学改变是已知的贡献者。ACL重建后，在日常生活活动和高水平活动期间观察到膝关节运动学和动力学的改变，并在ACL重建后持续长达两年。我们的总体研究目标是研究膝关节运动学和ACL重建后的运动学对关节软骨完整性和5年后膝关节力学的作用。第一个目标将确定ACL重建后的膝关节力学是否稳定，并跟踪至5年后。第二个目标将确定ACL重建后膝关节力学是否可预测ACL重建后5年的软骨完整性指标。在本研究中，我们将利用我们之前收集的30例初次单侧ACL重建后的生物力学和临床数据。我们将扩展我们以前收集的数据与磁共振成像和生物力学数据后5年的ACL重建在同一队列。三维膝关节运动学和动力学将量化膝关节力学，3-T MR成像将用于量化膝关节软骨的形态和组成（T1-rho和T2弛豫时间）特征。这种方法将允许立即测试我们的总体假设，即ACL重建后的膝关节力学在5年后仍然存在，并且与关节软骨完整性的测量相关。通过这个建议，我们将建立后ACL重建力学对早期软骨退变的潜在作用，推进膝关节OA早期发病机制的基础知识。本研究的成功完成将允许开发和测试ACL损伤患者的康复和手术治疗方案，这些方案可能更好地恢复膝关节力学，并最终可能减轻过早OA的发展。