COBRE: UD: PROJ 3: EFFECT OF IN-SHOE WEDGES ON KNEE OSTEOARTHRITIS

我们建议在特拉华大学建立一个卓越的生物医学研究中心，专注于骨关节炎的预防和治疗。该提案涉及三个研究项目，每个项目由一名初级教员领导，并由高级教员指导。在项目1中，Manal博士建议使用基于MRI和肌电图数据的生物医学模型来检查膝关节在进行日常生活活动时的运动学和动力学。项目2：鞋内楔形已被证明是一种有效的保守方法，以减轻骨关节炎患者的疼痛。这种疼痛减轻的机制尚不清楚。在我们的第三个项目中，Royer博士建议检查膝关节OA患者的鞋内楔对静态校准测量的影响。此外，还将检查这种治疗的长期效果。在项目3中，Rudolph博士建议研究膝内翻（“弓形腿”），这通常会导致膝盖内侧隔室的关节炎。对于膝内翻患者，通常通过切除膝关节下方胫骨外侧的楔形骨来矫正膝关节的排列，使关节表面更正常地排列（闭合楔形截骨术）。移除骨头会增加关节囊、肌肉和膝关节周围韧带的松弛度，并可能导致生物力学和肌肉反应问题的增加。另一种手术，开放楔形截骨术涉及在胫骨内侧创造一个开口，可以随着时间的推移慢慢分散。本研究的目的是描述开放楔形截骨术加骨痂牵引矫正膝内翻前后运动和肌肉活动的差异。

We propose to establish a center of biomedical research excellence at the University of Delaware that will focus on the prevention and treatment of osteoarthritis. This proposal involves three research projects, each lead by a junior faculty member who will be mentored by senior faculty. In Project 1, Dr. Manal proposes to use a biomedical model based on MRI and electromyographic data to examine knee kinematics and kinetics while performing activities of daily living. Project 2: In-shoe wedges have been shown to be an effective conservative approach in reducing pain in patients with osteoarthritis. The mechanism responsible for this pain reduction is not well understood. In our third project, Dr. Royer proposes to examine the examine the effects of in-shoe wedges in patients with knee OA on static alignment measures. In addition, the long-term effect of this treatment will also be examined. In Project 3, Dr. Rudolph proposes to study genu varum ("bowleggedness"), which often leads to arthritis on the medial compartment of the knee. Surgery is often performed to correct the alignment of the knee in people with genu varum by removing a wedge of bone on the lateral side of the tibia just below the knee joint to align the joint surfaces more normally (closing wedge osteotomy). Removing bone can increase the laxity of the joint capsule, muscles, and ligaments around the knee and may lead to increased problems with biomechanics and muscular responses. An alternative surgery, the opening wedge osteotomy involves the creation of an opening on the medial side of the tibia which can be distracted slowly over time. The purpose of this study is to characterize the differences in movement and muscle activity before and after an opening wedge osteotomy with callus distraction to correct genu varum.