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

点击翻译按钮获取中文摘要

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.