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

摘要 最近的数据表明，膝关节前交叉韧带(ACL)损伤上升速度最快的是 报告在儿童和青少年中仍有显著增长。在骨骼不成熟患者中 人群中，对于完全的前交叉韧带撕裂，越来越多的人建议手术重建。然而，选择 非手术治疗或立即手术重建前交叉韧带撕裂在年轻患者中仍是一个争论的主题 仍有明显生长的患者或部分撕裂累及一个前交叉韧带束的患者。性爱出现了 在青春期是前交叉韧带损伤的主要危险因素，但在儿童时期不是，增加了另一层 复杂性。对于完全和部分前交叉韧带损伤，已经开发了治疗算法，而没有 考虑到由于现有数据的缺乏，前交叉韧带可能具有性别和年龄相关的功能。 因此，本研究的目的是确定年龄和性别对前交叉韧带成熟和关节功能的影响。 并评估这一知识是否可以应用于改善前交叉韧带损伤后的治疗。 目标1将确定性别如何影响前交叉韧带及其个体AM和PL的成熟 在骨骼生长过程中的束。目标2将确定年龄和性别如何影响即刻负荷 AM功能丧失后的体外次级组织和体内关节重塑反应 捆绑包、PL捆绑包或整个ACL。目标3将确定替换移植物的类型和放置方式 改变以恢复特定年龄和性别的前交叉韧带和关节功能。成功完成这些目标将提供一个 开发针对年龄和性别的治疗前交叉韧带算法的基础科学基础 受伤。 好了！

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. !