ACL Reconstruction in the Female Athlete: Strength, Knee Mechanics and Outcome

描述（由申请人提供）：骨关节炎（OA）是最常见的关节疾病之一，通常会导致严重残疾。尽管发病率高，但关于OA的发病机制知之甚少，尽管涉及细胞和生物力学机制。膝关节OA通常发生在前交叉韧带（ACL）损伤后，尽管进行了手术重建，特别是在女性中。女性运动员ACL损伤的高发生率，加上未来关节损伤的高风险，促使研究该人群中膝关节OA发展的潜在机制。前交叉韧带重建后股四头肌力量不足是常见的，在结构化康复和患者恢复高水平活动后持续很长时间。股四头肌无力与关节力学改变有关，可能会传播关节软骨损伤。关于股四头肌力量受损对高水平活动期间关节力学或纵向临床结局的影响，目前知之甚少。人们怀疑，如果前交叉韧带重建的运动员返回到高水平的活动，并使他们的膝盖暴露于大量的力量，而没有正常的股四头肌力量和关节力学，关节软骨损伤的条件可能会启动和传播。ACL重建后安全恢复高水平运动活动的适当指南尚不清楚。女性运动员是ACL损伤患者中的一个独特亚群，一些独特的特征表明她们对ACL损伤和ACL重建的反应可能与男性不同。本提案的具体目的包括仔细纵向检查残余股四头肌力量缺陷对膝关节力学和ACL重建女性运动员功能结局的影响。这项研究代表了一个全面的调查，女运动员后ACL重建，并将作为一个必要的步骤，建立安全和适当的康复指南。膝关节OA是一种进行性关节疾病，通常会导致严重疼痛和残疾。ACL损伤的个体尽管进行了ACL重建，但仍有发生膝关节OA的巨大风险。这项研究将提供有关ACL损伤和重建后关节炎关节变化的潜在机制的有价值的信息。这项研究的信息将作为未来研究的跳板，具体的干预措施，可能会降低女性运动员ACL损伤后关节炎关节变化的风险。

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is one of the most prevalent joint disorders that often leads to severe disability. Despite the incidence, relatively little is known regarding the pathogenesis of OA although both cellular and biomechanical mechanisms are implicated. Knee OA commonly develops following anterior cruciate ligament (ACL) injury despite surgical reconstruction, particularly in females. The high incidence of ACL injuries in female athletes, combined with the high risk for future joint damage, motivates investigation of mechanisms underlying the development of knee OA in this population. Quadriceps strength deficits are common following ACL reconstruction and persist long after structured rehabilitation and after patients have returned to high-level activities. Quadriceps muscle weakness is associated with altered joint mechanics that may propagate articular cartilage damage. Little information is known regarding the impact of impaired quadriceps strength on joint mechanics during high-level activities or on longitudinal clinical outcomes. It is suspected that if athletes with ACL reconstruction return to high-level activities and expose their knee to substantial forces without normalized quadriceps strength and joint mechanics, the conditions for articular cartilage damage may be initiated and propagated. Appropriate guidelines for safe return to high-level sport activities following ACL reconstruction are not known. Female athletes are a unique subpopulation within those with ACL injury, and several unique characteristics suggest that they may respond to ACL injury and ACL reconstruction differently than males. The Specific Aims of this proposal involve careful, longitudinal examination of the impact of residual quadriceps strength deficits on knee joint mechanics and on functional outcomes in female athletes with ACL reconstruction. This study represents a comprehensive investigation of female athletes following ACL reconstruction and will serve as a necessary step in establishing safe and appropriate rehabilitation guidelines. Knee OA is a progressive joint disease that often leads to severe pain and disability. Individuals with ACL injury have substantial risk of developing knee OA despite ACL reconstruction. This investigation will provide valuable information regarding potential mechanisms involved in the initiation of arthritic joint changes following ACL injury and reconstruction. Information from this study will serve as springboard for future research of specific interventions that may reduce the risk of arthritic joint changes following ACL injury in female athletes.