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）损伤的最快增长率是 报告的儿童和青少年仍有显著增长。在心智不成熟的病人身上 在人群中，越来越多的人建议对ACL完全撕裂进行手术重建。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。 保留显著生长的患者或涉及一束ACL的部分撕裂的患者。性似乎 是青少年时期ACL损伤的主要危险因素，但不是在儿童时期，增加了另一层 复杂性对于完全和部分ACL损伤，已经开发了治疗算法， 考虑到ACL的潜在性别和年龄依赖性功能，由于缺乏可用数据。 因此，本提案的目的是确定年龄和性别如何影响ACL成熟和关节功能 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的成熟以及其个体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 体外次级组织和AM功能丧失后体内关节的重塑反应 包、PL包或整个ACL。目标3将确定置换移植物的类型和位置， 根据不同的年龄和性别选择不同的ACL和关节功能。成功实现这些目标将为 开发针对特定年龄和性别的ACL治疗算法的基础科学基金会 受伤 !

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. !