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.

项目概要 本行政补充文件 (NOT-OD-20-54) 随附家长 K01 (K01AR081389；PI：Harkey 博士) 并要求提供补充支持，资助更多的研究人员，以促进研究的连续性 哈基博士儿子出生后第一年的关键时期。对于至少三分之一的年轻人来说 前交叉韧带重建 (ACLR) 中，受伤和手术是关键的生活事件，导致 慢性疼痛、长期生活质量下降以及骨关节炎 (OA) 风险增加。由于穷 症状和放射学前结构病理学是膝关节 OA 发生的危险因素， 了解与第一年不良症状和结构性结果相关的可改变的风险因素 未来的研究需要 ACLR 后来确定预防 OA 的疗法。 5年家长目标 K01 用于确定如何在 3 时评估体力活动 (PA) 和步行生物力学的纵向变化， ACLR 后 6、9 和 12 个月与 ACLR 后第一年的不良症状或结构性结果相关。 这将是第一项将以下结果应用于第一年多次就诊的年轻人的研究 ACLR 后：1) 早期 OA 症状的分类标准，2) 临床可用的全膝超声检查 检测多种结构病理的评分系统。 PA 将使用研究级加速度计进行评估 量化每次运动后 7 天内每天和每周中度至剧烈 PA 的步数 考察访问。步行生物力学将在动作捕捉实验室进行评估，以量化垂直地面 反作用力和膝内收力矩。我的中心假设是，具有中等程度的参与者 ACLR 后 PA 和步行生物力学的变化不太可能出现症状和结构不良 与 PA 和步行快速增加或没有变化的人相比，第一年的结果 生物力学。这项工作的预期结果是确定：1​​）ACLR 后的高危患者是理想的患者 旨在预防不良症状和结构结果的临床试验的参与者，以及 2) 当 PA 或 ACLR 术后第一年需要针对步行生物力学进行目标。该提案还将提供博士。 Harkey 接受培训和指导，开发全膝超声成像、设备- 基于 PA 监测、纵向数据分析和临床试验设计。迄今为止，Harkey 博士的父母 K01 项目和培训正按原定时间表进行，所要求的补充支持将确保 K01时间线的连续性。该支持将资助一名研究生，负责协调和继续研究 哈基医生需要照顾他的时间期间的活动（例如，患者招募和数据收集） 增加的家庭责任。该补充材料将支持母体 K01 的研究和培训目标 因为这将有助于 Harkey 博士在休假后无缝返回工作岗位并充分发挥生产力。

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