A Multi-center Cohort Study of ACL Reconstruction Outcomes

候选人：沃伦·R·邓恩，医学博士，公共卫生硕士，范德比尔特大学骨科助理教授，拥有 二次聘任该中心医学与公共卫生系助理教授 卫生服务研究中心。他完成了美国整形外科医生学会/整形外科 研究与教育基金会特殊医院健康服务研究奖学金 运动医学和肩部服务的外科。在这份K23应用程序中，他提出了一个全面的 五年职业发展计划，包括临床流行病学的高级课程和培训， 生物统计学，临床试验设计，并进行指导性研究项目，调查结果 重建前交叉韧带(ACL)以达到自立的目的 外科医生科学家。项目理念：体力活动和健身是健康人关注的领域之一 2010年，体育参与度在不断增加。根据前交叉韧带损伤的数量和后续的前交叉韧带 重建工程正在增加，估计每年花费20亿美元。可获得的证据表明 前交叉韧带重建术在两年后成功地恢复了术前功能，但这些研究 使用未经验证的结果衡量标准，往往缺乏长期随访，并将风险因素留在 预后不佳，移植物失败，以及其他手术程序定义不清。设计：多中心 涉及已建立的多中心骨科结果网络(MOUNE)的观察性队列研究 将会被利用。建议的指导性研究的目的是检验这样一种假设： 在前交叉韧带重建时记录的预测指标与有效的结果工具和 关节炎(目标1)，以及其他外科手术和移植失败(目标2)。范德比尔特是一位健壮的学者 能够提供必要的教育、培训和指导的环境，使邓恩博士能够 成为一名独立的、以患者为中心的临床医生科学家。 前交叉韧带是人体内最常见的损伤韧带，而这一重要的稳定器的破坏会导致 让位于导致膝盖进一步受伤的插曲。前交叉韧带重建使膝盖恢复稳定， 然而，目前还不清楚手术是否能预防以后的膝关节炎。确定与质量相关的因素 生活和关节炎是至关重要的，因为关节炎，特别是年轻人的关节炎，是一个主要的公共卫生问题。

Candidate: Warren R. Dunn, MD, MPH, Assistant Professor of Orthopaedics at Vanderbilt University with a secondary appointment as Assistant Professor in the Department of Medicine & Public Health at the Center for Health Services Research. He completed the American Academy of Orthopaedic Surgeons / Orthopaedic Research and Education Foundation Health Services Research Fellowship at the Hospital for Special Surgery on the Sports Medicine and Shoulder Service. In this K23 application he proposes a comprehensive five-year career development plan that includes advanced coursework and training in clinical epidemiology, biostatistics, clincal trial design, and to conduct a mentored research project investigating outcomes after anterior cruciate ligament (ACL) reconstruction in order to achieve the goal of becoming an independent surgeon scientist. Project Rationale: Physical activity and fitness is one of the focus areas of Healthy People 2010, and sports participation is increasing. In accord, the number of ACL injuries and subsequent ACL reconstructions is increasing at an estimated annual cost of 2 billion dollars. Available evidence shows that ACL reconstructions have been successful in restoring preoperative function at two years, but these studies have utilized non-validated outcome measures, often lack long-term follow-up, and have left risk factors for poor outcome, graft failure, and additional surgical procedures ill defined. Design: A multi-center observational cohort study involving an established Multi-center Orthopaedic Outcomes Network (MOON) will be utilized. The purpose of the proposed mentored research is to test the hypothesis that objective predictors recorded at the time of ACL reconstruction are associatedwith validated outcome instruments and arthritis (Aim 1), and additional surgical procedures and graft failure (Aim 2). Vanderbilt is a robust academic environment capable of providing the education, training, and mentorship necessary to enable Dr. Dunn to become an independent patient-oriented clinician scientist. The ACL is the most frequently injured ligament in the body, and disruption of this important stablizer leads to giving way episodes that cause further injury to the knee. ACL reconstruction restores stability to the knee, however, it is unclear if surgery prevents later arthritis of the knee. Identifying factors associated with quality of life and arthritis is critical because arthritis, particularly in young adults, is a major public health concern.