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，通常会导致严重的残疾。尽管发病率高，但对OA的发病机制知之甚少，尽管涉及细胞和生物力学机制。膝关节骨关节炎通常发生在前交叉韧带（ACL）损伤后，尽管手术重建，特别是在女性中。女性运动员的前交叉韧带损伤发生率高，加上未来关节损伤的高风险，促使人们对这一人群中膝关节OA发展的机制进行研究。股四头肌力量不足在前交叉韧带重建后很常见，并在有组织康复和患者恢复高水平活动后长期存在。股四头肌无力与关节力学改变有关，可传播关节软骨损伤。关于高水平活动中受损的股四头肌力量对关节力学的影响或对纵向临床结果的影响知之甚少。我们怀疑，如果前交叉韧带重建的运动员恢复高水平活动，在没有规范的股四头肌力量和关节力学的情况下，将膝关节暴露在巨大的力量下，可能会引发并传播关节软骨损伤的条件。ACL重建后安全恢复高水平体育活动的适当指南尚不清楚。在前交叉韧带损伤的人群中，女性运动员是一个独特的亚群，一些独特的特征表明，她们对前交叉韧带损伤和前交叉韧带重建的反应可能与男性不同。本建议的具体目的包括仔细的纵向检查残余股四头肌力量缺陷对前交叉韧带重建的女运动员膝关节力学和功能结局的影响。本研究对女性运动员前交叉韧带重建进行了全面调查，并将为建立安全和适当的康复指南提供必要的步骤。膝关节炎是一种进行性关节疾病，常导致严重疼痛和残疾。尽管前交叉韧带重建，但前交叉韧带损伤的个体仍有很大的风险发生膝关节炎。本研究将为前交叉韧带损伤和重建后引发关节炎性关节改变的潜在机制提供有价值的信息。这项研究的信息将为未来研究特定干预措施提供跳板，这些干预措施可能会降低女运动员前交叉韧带损伤后关节关节炎改变的风险。

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.