Sex- and Age-dependent ACL Function in the Growing Knee Joint

膝关节生长过程中 ACL 功能的性别和年龄依赖性

• 批准号: 9524108
• 负责人: Matthew B Fisher
• 金额: $ 32.35万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9524108
• 关键词: Adolescence; Adolescent; Aftercare; Age; Algorithms; Anatomy; Animals; Anterior Cruciate Ligament; Autologous; Basic Science; Biochemical; Biological Assay; Biomechanics; Birth; Child; Childhood; Data; Data Science; Degenerative polyarthritis; Development; Evaluation; Experimental Designs; Family suidae; Female; Fiber; Foundations; Geometry; Goals; Growth; Histologic; Image; In Vitro; Incidence; Individual; Injury; Joints; Knee; Knee Injuries; Knee joint; Knowledge; Medial; Medial meniscus structure; Modeling; Modification; Operative Surgical Procedures; Orthopedic Surgery procedures; Patients; Pattern; Phase; Procedures; Property; Public Health; Reporting; Risk Factors; Robotics; Role; Site; Specimen; Sports; Structure; System; Techniques; Testing; Tissue imaging; Tissues; Validation; Veterinary Medicine; Youth; age related; anterior cruciate ligament reconstruction; anterior cruciate ligament rupture; base; clinically relevant; collateral ligament; early adolescence; experience; improved; in vivo; joint function; joint loading; ligament development; ligament injury; loss of function; male; mechanical properties; multidisciplinary; patient population; reconstruction; response; sex; skeletal; soft tissue; statistics; treatment strategy

ABSTRACT Recent data indicates that the fastest rising rates of anterior cruciate ligament (ACL) injuries of the knee are reported in children and adolescents with significant growth remaining. In the skeletally immature patient population, surgical reconstruction is increasingly suggested for complete ACL tears. However, the choice of non-surgical treatment or immediate surgical reconstruction of ACL tears remains a subject of debate in young patients with significant growth remaining or in the case of partial tears involving one ACL bundle. Sex appears to be a major risk factor for ACL injury during adolescence, but not in childhood, adding another layer of complexity. For both complete and partial ACL injuries, treatment algorithms have been developed without considering the potential sex- and age-dependent function of the ACL, due to the paucity of available data. Thus, the objective of this proposal is to determine how age and sex impact ACL maturation and joint function during skeletal growth and to assess if this knowledge can be applied to improve treatment after ACL injury. Aim 1 will determine how sex impacts the maturation of the ACL as well as that of its individual AM and PL bundles during skeletal growth. Aim 2 will determine how age and sex impact the immediate loading of secondary tissues in-vitro and the remodeling response of the joint in-vivo following loss of function of the AM bundle, PL bundle, or the entire ACL. Aim 3 will determine how replacement graft type and placement should vary to restore age- and sex-specific ACL and joint function. Successful completion of these aims will provide a basic science foundation for the development of age- and sex-specific algorithms for the treatment of ACL injuries. !

抽象的 最近的数据表明，膝关节前交叉韧带 (ACL) 损伤的发病率上升最快的是 据报道，儿童和青少年仍显着生长。对于骨骼尚未成熟的患者 对于完全 ACL 撕裂，越来越多的人建议进行手术重建。然而，选择 ACL 撕裂的非手术治疗或立即手术重建仍然是年轻人争论的话题 具有明显生长剩余的患者或涉及一根 ACL 束部分撕裂的患者。性出现 是青春期 ACL 损伤的主要危险因素，但在儿童期则不然，这又增加了一层 复杂。对于完全和部分 ACL 损伤，已经开发出治疗算法，无需 由于缺乏可用数据，考虑到 ACL 潜在的性别和年龄依赖性功能。 因此，该提案的目标是确定年龄和性别如何影响 ACL 成熟和关节功能 骨骼生长期间的知识，并评估这些知识是否可以应用于改善 ACL 损伤后的治疗。 目标 1 将确定性别如何影响 ACL 及其个体 AM 和 PL 的成熟 骨骼生长过程中的束。目标 2 将确定年龄和性别如何影响立即负荷 体外次生组织和 AM 功能丧失后体内关节的重塑反应 束、PL 束或整个 ACL。目标 3 将确定置换移植物的类型和放置方式 以恢复特定年龄和性别的 ACL 和关节功能。成功完成这些目标将提供 开发治疗 ACL 的年龄和性别特异性算法的基础科学基础 受伤。 ！