Walk this Way: Physical Activity and Walking Biomechanics Lead to Early Knee OA Symptoms and Ultrasound-Detected Structural Pathology after ACL Reconstruction

以此方式行走：体力活动和行走生物力学导致 ACL 重建后早期膝关节 OA 症状和超声检测的结构病理学

• 批准号: 10732572
• 负责人: Matthew Harkey
• 金额: $ 5.29万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10732572
• 关键词: Accelerometer; Administrative Supplement; Biomechanics; Birth; Classification; Clinical; Clinical Trials Design; Data Analyses; Data Collection; Degenerative polyarthritis; Development; Devices; Ensure; Event; Evidence based intervention; Family; Funding; Future; Injury; Knee; Knee Osteoarthritis; Laboratories; Lead; Life; Mentors; Monitor; Motion; Operative Surgical Procedures; Outcome; Parents; Participant; Pathology; Patient Recruitments; Patients; Persons; Physical activity; Productivity; Quality of life; Reaction; Research; Research Activity; Risk; Risk Factors; Son; Symptoms; System; Time; Training; Ultrasonography; Visit; Walking; Work; adduct; anterior cruciate ligament reconstruction; biomechanical test; chronic pain; clinical trial participant; graduate student; moderate-to-vigorous physical activity; modifiable risk; novel; prevent; radiological imaging; risk mitigation; skills; timeline; ultrasound; young adult

PROJECT SUMMARY This administrative supplement (NOT-OD-20-54) accompanies the Parent K01 (K01AR081389; PI: Dr. Harkey) and requests supplementary support to fund additional research staff to promote the continuity of research during the critical time within the first year following the birth of Dr. Harkey’s son. For at least 1 in 3 young adults with an anterior cruciate ligament reconstruction (ACLR), the injury and surgery are pivotal life events that lead to chronic pain, diminished long-term quality of life, and an increased risk for osteoarthritis (OA). Since poor symptoms and pre-radiographic structural pathology are risk factors for the development of knee OA, understanding modifiable risk factors that relate to poor symptomatic and structural outcomes during the 1st year post-ACLR is needed for future studies to identify therapies that prevent OA. The objective of the 5-year Parent K01 is to determine how longitudinal changes in physical activity (PA) and walking biomechanics assessed at 3, 6, 9, and 12 months post-ACLR relate to poor symptomatic or structural outcomes during the 1st year post-ACLR. This will be the first study that applies the following outcomes to young adults at multiple visits during the 1st year post-ACLR: 1) classification criteria for early OA symptoms, 2) clinically accessible whole-knee ultrasound scoring system to detect multiple structural pathologies. PA will be assessed with research-grade accelerometers to quantify steps per day and weekly minutes of moderate to vigorous PA during a 7-day period following each study visit. Walking biomechanics will be assessed in a motion capture laboratory to quantify vertical ground reaction force and internal knee adduction moment. My central hypothesis is that participants with a moderate change in PA and walking biomechanics post-ACLR will be less likely to have poor symptomatic and structural outcomes during the 1st year when compared to people with a rapid increase or no change in PA and walking biomechanics. The expected outcome of this work is to identify: 1) at-risk patients post-ACLR who are the ideal participants for clinical trials aimed at preventing poor symptomatic and structural outcomes, and 2) when PA or walking biomechanics need to be targeted during the 1st year post-ACLR. This proposal will also provide Dr. Harkey with the training and mentoring to develop a novel skill set in whole-knee ultrasound imaging, device- based PA monitoring, longitudinal data analyses, and clinical trial design. To date, Dr. Harkey’s Parent K01 project and training is on track with the original timeline and the requested supplemental support will ensure continuity of the K01 timeline. The support will fund a graduate student that will coordinate and continue research activities (e.g., patient recruitment and data collection) during times when Dr. Harkey is required to tend to his increased family responsibilities. This supplement will support both the parent K01 research and training aims as it will aid in Dr. Harkey’s seamless return to work and full productivity following leave.

项目总结 此行政补充(非-OD-20-54)随父母K01(K01AR081389；PI：Dr.Harkey)一起提供 并要求提供补充支助，为增加研究人员提供经费，以促进研究在#年的连续性 哈基医生的儿子出生后第一年内的关键时刻。对于至少1/3的年轻人来说， 作为前十字韧带重建术(ACLR)，损伤和手术是导致 慢性疼痛，降低长期生活质量，增加患骨关节炎(OA)的风险。既然穷了 症状和X线片前结构病理是膝骨性关节炎发生的危险因素， 在第一年了解与不良症状和结构性结果相关的可改变的风险因素 ACLR后需要用于未来的研究，以确定预防OA的治疗方法。5岁父母的目标 K01是为了确定在3岁时体力活动(PA)和行走生物力学的纵向变化， ACLR术后6个月、9个月和12个月与ACLR术后第一年的症状或结构结果较差有关。 这将是第一项将以下结果应用于第一年多次访问的年轻人的研究 ACLR术后：1)早期骨性关节炎症状的分类标准，2)临床可及的全膝关节超声 用于检测多种结构病变的评分系统。PA将使用研究级加速度计进行评估 在接下来的7天时间里，量化每天和每周中等强度到剧烈运动的步数 参观考察。行走生物力学将在运动捕捉实验室进行评估，以量化垂直地面 反作用力和内收力矩。我的中心假设是，患有中度肥胖的参与者 ACLR术后PA和步行生物力学的变化不太可能出现不良的症状和结构 与PA和步行能力迅速增加或无变化的人相比，第一年的结果 生物力学。这项工作的预期结果是：1)ACLR术后的高危患者是理想的 参与者参加旨在预防不良症状和结构性结果的临床试验，以及2)当PA或 在ACLR术后的第一年，步行生物力学需要进行针对性的训练。这项提案还将为Dr。 哈基通过培训和指导，开发了一套新的全膝超声成像技术，设备- 基于PA监测、纵向数据分析和临床试验设计。到目前为止，哈基博士的父母K01 项目和培训正在按原时间表进行，所请求的补充支持将确保 K01时间线的连续性。这笔资助将资助一名研究生，他将协调并继续进行研究 在哈基医生需要照顾他的时候的活动(例如，招募病人和收集数据) 增加家庭责任。这一补充将支持母公司K01的研究和培训目标 因为这将有助于哈基博士在休假后无缝重返工作岗位和全面提高生产率。

项目成果

Ultrasound assessment of the infrapatellar fat pad can detect Hoffa-synovitis in patients following anterior cruciate ligament reconstruction: A pilot study.

髌下脂肪垫的超声评估可以检测前十字韧带重建后患者的霍法滑膜炎：一项试点研究。

• DOI: 10.1016/j.ostima.2024.100174
• 发表时间: 2024
• 期刊: Osteoarthritis imaging
• 作者: Fagan,M;Fajardo,R;Grozier,C;Jildeh,TR;Lissy,M;Harkey,MS
• 通讯作者: Harkey,MS

Ultrasound-detected effusion-synovitis is associated with greater limb loading rate asymmetry during walking post-ACL reconstruction: A pilot study.

超声检测的积液滑膜炎与 ACL 重建后行走期间更大的肢体负荷率不对称相关：一项试点研究。

• DOI: 10.1016/j.ostima.2024.100175
• 发表时间: 2024
• 期刊: Osteoarthritis imaging
• 作者: Harkey,MatthewS;Grozier,CoreyD;Tolzman,Jessica;Parmar,Arjun;Fagan,Molly;Collins,Katherine;Kuenze,Christopher;Fajardo,Ryan
• 通讯作者: Fajardo,Ryan

Rectus Femoris Ultrasound Echo Intensity Is a Valid Estimate of Percent Intramuscular Fat in Patients Following Anterior Cruciate Ligament Reconstruction.

• DOI: 10.1016/j.ultrasmedbio.2023.08.027
• 发表时间: 2023-09
• 期刊: Ultrasound in medicine & biology
• 影响因子: 2.9
• 作者: C. Grozier;Megan Keen;K. Collins;Jessica Tolzman;Ryan Fajardo;Jill M. Slade;Christopher Kuenze;Matthew S. Harkey

Persistent Early Knee Osteoarthritis Symptoms in the First Two Years After ACL Reconstruction.

ACL 重建后头两年内持续出现早期膝骨关节炎症状。

• DOI: 10.4085/1062-6050-0470.23
• 发表时间: 2024
• 期刊: Journal of athletic training
• 影响因子: 3.3
• 作者: Harkey,MatthewS;Driban,JeffreyB;Baez,ShelbyE;Genoese,FrancescaM;Reiche,Elaine;Collins,Katherine;Walaszek,MichelleC;Triplett,Ashley;Wilcox,CL;Schorfhaar,Andrew;Shingles,Michael;Joseph,Sheeba;Kuenze,Christopher
• 通讯作者: Kuenze,Christopher