Knee Arthrosis after ACL Reconstruction: A Long-term Cohort Study with Matched Controls
ACL 重建后的膝关节炎:具有匹配对照的长期队列研究
基本信息
- 批准号:10424422
- 负责人:
- 金额:$ 31.56万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-05-10 至 2024-04-30
- 项目状态:已结题
- 来源:
- 关键词:AnteriorAnterior Cruciate LigamentAutologous TransplantationCaringClinicalClinical ResearchClinical TrialsContralateralControl GroupsDataDegenerative polyarthritisDevelopmentEconomic BurdenEnrollmentEpidemicFemaleFemurFrequenciesFundingFutureHealthImageIncidenceInjuryJointsKneeKnee InjuriesKnee OsteoarthritisKnee jointLong-Term EffectsLongitudinal StudiesLongitudinal cohort studyLongterm Follow-upMeasuresMechanicsMedialModificationMonitorOperative Surgical ProceduresOutcomeOutcome MeasurePatientsPopulationProcessProtocols documentationRandomizedRandomized Controlled TrialsReconstructive Surgical ProceduresReportingRiskRisk FactorsRoentgen RaysSex DifferencesSex FactorsTechniquesTimeTraumatic ArthropathyUnited States National Institutes of HealthWidthWorkanterior cruciate ligament injuryanterior cruciate ligament reconstructionbasecartilage degradationcohortdesignfollow-upfunctional outcomesfunctional restorationgraft failurehigh riskimaging modalitymalenovelpatient orientedpreventprimary outcomeradiological imagingreconstructionrecruitretention ratesample fixationsecondary outcomesextibiatreatment grouptreatment guidelinestrendtrial comparing
项目摘要
PROJECT SUMMARY/ABSTRACT
The objectives of this longitudinal outcome study are to evaluate the progression of post-traumatic
osteoarthritis (PTOA) following surgical reconstruction of the anterior cruciate ligament (ACL) in male and
female patients 15 years after surgery, and to determine if the initial tension applied to the graft at the time of
surgery and if sex influences long-term outcomes related to arthrosis. Disruption of the ACL is a common injury
that usually requires surgical reconstruction to restore function and prevent PTOA. The “initial graft tension”
applied at the time of surgery modulates joint contact mechanics, which in turn, may promote PTOA. However,
the effects of low- and high-initial graft tensions on PTOA development are unknown. It is also known that sex
is a risk factor for ACL injury and subsequent graft failure. Thus, it is likely that females are at increased risk for
PTOA following surgery. The proposed work will leverage a cohort of ACL reconstructed patients that were
previously enrolled in a randomized control trial to study the effects of initial graft tension. Patients, who were
candidates for ACL reconstruction with an autograft, were randomized into one of two treatment groups: 1)
initial graft tension set such that the anterior-posterior (AP) laxity of the reconstructed knee was equal to that of
the contralateral normal knee (the “low-tension” treatment; n=46), and 2) initial graft tension set to reduce AP
knee laxity by 2 mm relative to that of the contralateral knee (the “high-tension” treatment; n=44). An additional
group of subjects without evidence of knee injury (n=60) was recruited to serve as an uninjured control. In the
previous funding cycle, we found differences in several outcome measures starting to emerge between the two
initial graft tension groups at 7-year follow-up that were not present at 3-year follow-up. In this proposal, the
follow-up of this patient cohort and its matched control group will be extended to 15 years, a time point that will
enable us to clearly identify those patients who present with both radiographic and symptomatic PTOA. The
first hypothesis is that tibiofemoral joint space width of the reconstructed knees of the “high-tension” cohort will
be equal to that of the control group, while that of the “low-tension” cohort will be less than that of the control
group 15 years after ACL reconstruction. The second hypothesis is that decreases in medial joint space width
after ACL reconstruction will be greater in female patients compared to male patients. The comprehensive set
of outcomes to be used include imaging modalities to monitor PTOA development and other validated patient-
reported, clinical, and functional measures. X-ray measures of joint space width are considered the only
validated indicator of PTOA progression for clinical trials of the knee, and will serve as the primary outcome
measure for the proposed study. Radiographic assessment of joint health (OARSI score) and a MR-based
measure of joint health (WORMS) will serve as secondary imaging outcomes. The Knee Osteoarthritis
Outcome Score (KOOS) will be used to identify which patients have symptomatic PTOA. The comprehensive
set of outcomes will allow us to establish the long-term effects of initial graft tension, and to systematically
evaluate the effects of sex on PTOA development following ACL reconstruction surgery. The proposed study is
novel as the ACL reconstructed cohort is comprised of patients with isolated unilateral ACL injuries at the time
of injury, includes the long-term follow-up required to assess PTOA development in these patients, and
includes a matched control group in order to compare arthrosis development in the uninjured population.
项目总结/文摘
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Braden C Fleming其他文献
Braden C Fleming的其他文献
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{{ truncateString('Braden C Fleming', 18)}}的其他基金
Knee Arthrosis after ACL Reconstruction: A Long-term Cohort Study with Matched Controls
ACL 重建后的膝关节病:一项具有匹配对照的长期队列研究
- 批准号:
10159846 - 财政年份:2019
- 资助金额:
$ 31.56万 - 项目类别:
Planning A Clinical Trial of Bio-enhanced ACL Repair versus ACL Reconstruction
计划生物增强 ACL 修复与 ACL 重建的临床试验
- 批准号:
9233601 - 财政年份:2017
- 资助金额:
$ 31.56万 - 项目类别:
Non-invasive assessment of ligament healing in vivo
体内韧带愈合的无创评估
- 批准号:
8928046 - 财政年份:2014
- 资助金额:
$ 31.56万 - 项目类别:
Non-invasive assessment of ligament healing in vivo
体内韧带愈合的无创评估
- 批准号:
8759439 - 财政年份:2014
- 资助金额:
$ 31.56万 - 项目类别:
Non-invasive assessment of ligament healing in vivo
体内韧带愈合的无创评估
- 批准号:
9136641 - 财政年份:2014
- 资助金额:
$ 31.56万 - 项目类别:
Biologically Enhanced Healing of Autograft ACL Reconstruction.
自体移植 ACL 重建的生物增强愈合。
- 批准号:
8020913 - 财政年份:2009
- 资助金额:
$ 31.56万 - 项目类别:
Biologically Enhanced Healing of Autograft ACL Reconstruction.
自体移植 ACL 重建的生物增强愈合。
- 批准号:
8213690 - 财政年份:2009
- 资助金额:
$ 31.56万 - 项目类别:
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