Role of musculoskeletal biomechanical factors in cartilage loss in those who undergo partial medial menisectomy.

我们项目的新成果是，我们将确定可以修改的肌肉骨骼生物力学因素是否与膝骨性关节炎风险增加的一组人(那些经历了APM的人)的软骨不良变化有关。这项研究的结果是及时的，具有重大的国际意义，因为人们越来越重视预防骨性关节炎，而不仅仅是治疗症状和体征。我们最先进的软骨变化测量方法将使我们能够比使用X光照片的传统测量方法更快地发现那些处于危险中的人。这些措施在国际上也处于领先地位。我们选择这些特定的因素进行调查，因为有证据表明，通过适当的干预可以改变这些因素。例如，静态关节对齐可以通过足部矫形器来改变[Crenshaw，2000#1016]，肌肉无力可以通过力量计划来解决，膝关节上的机械负荷可以通过减肥计划或改变步态模式的技术来减少。目前，在APM后，正式的有监督的术后康复并不是常规的处方，因为这被认为是一种常规程序。如果我们的研究确定了软骨丢失增加的危险因素，那么我们将能够为急性早幼粒细胞白血病患者制定适当的干预策略。然后，可以使用随机对照试验来正式测试这些干预措施在减少软骨不良变化方面的有效性。特别是，这可能会导致这一患者群体目前的术后临床实践发生变化。最终，这可以降低未来发生骨性关节炎的风险，以及由此产生的个人和社会成本。

The novel outcomes from our project are that we will identify whether musculoskeletal-biomechanical factors that can be modified are associated with adverse cartilage changes in a subgroup of individuals with an increased risk of developing knee OA, those who have undergone an APM. The findings of this research are timely and of major international significance as there is increasing attention being paid to preventing OA rather than merely treating the signs and symptoms. Our state-of-the-art measure of cartilage changes will allow us to detect those at risk much sooner than traditional measures using radiographs. The measures are also leading edge internationally. We chose these specific factors to investigate as there is evidence that they can be modified with appropriate interventions. For example, static joint alignment could be modified with foot orthoses [Crenshaw, 2000 #1016], muscle weakness can be addressed with strength programs and mechanical loading across the knee could be reduced via weight loss programs or techniques to alter gait patterns. Currently, formal supervised post-operative rehabilitation is not routinely prescribed following APM because it is considered a routine procedure. If our research identifies risk factors for increased cartilage loss then we will be able to develop appropriate intervention strategies for individuals following an APM. These interventions can then be formally tested as to their effectiveness in reducing adverse cartilage changes using randomised controlled trials. In particular, this could lead to changes in current post-operative clinical practice for this patient group. Ultimately, this could reduce the risk of OA in the future and the resultant personal and societal costs of this condition.