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.

项目摘要 这种行政补充（NOT-OD-20-54）涉及家长K01（K01AR081389; PI：Harkey博士） 并要求补充支持资助其他研究人员，以促进研究的连续性 Harkey儿子出生后第一年的关键时间。至少有三分之一的年轻人 损伤和手术是前交叉韧带重建（ACLR）是导致的关键生命事件 慢性疼痛，长期生活质量减少以及骨关节炎（OA）的风险增加。自从贫穷 症状和记录前结构病理学是膝盖OA发展的危险因素， 了解与症状不良和结构性结果相关的可修改风险因素 将来的研究需要进行鉴定的疗法，因此需要在-ACLR之后。 5年父母的目标 K01是确定体育活动（PA）和步行生物力学在3时的纵向变化， ACLR后的6、9和12个月与ACLR 1年期间的症状或结构性结果不良有关。 这将是第一项在第一年中多次访问的年轻人应用以下结果的研究 后ACLR：1）早期OA符号的分类标准，2）临床上易于访问的全膝盖超声 评分系统以检测多种结构病理。 PA将使用研究级加速度计进行评估 在每天的7天期间，每天量化每天的台阶和每周的现代阶段到剧烈的PA 研究访问。步行生物力学将在运动捕获实验室中进行评估，以量化垂直地面 反作用力和内部膝盖添加力矩。我的中心假设是，具有现代的参与者 ACLR后PA和步行生物力学的变化不太可能患有症状和结构性较差 与在PA迅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识别：1）在ACLR之后处于理想的ACLR风险患者 旨在防止症状和结构性结果不良的临床试验的参与者，以及2）PA或 行走生物力学需要在ACLR之后的第一年中成为目标。该建议还将为博士提供。 Harkey进行了训练和心理，以发展全膝盖超声影像，设备的新技能 - 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 项目和培训与原始时间表有关，所请求的补充支持将确保 K01时间轴的连续性。支持将资助一个研究生，该研究生将协调并继续研究 在要求Harkey博士趋向于他的时期，活动（例如，患者招聘和数据收集） 增加家庭责任。该补充剂将支持家长K01研究和培训目的 因为这将有助于Harkey博士在休假后的无缝恢复工作和全部生产力。

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