Prospective study of biomechanics and early degeneration after ACL reconstruction

描述(由申请人提供)：膝关节骨关节炎(OA)的早期发展在前十字韧带(ACL)损伤后越来越常见。前交叉韧带损伤是青少年和青壮年最常见和最令人衰弱的运动损伤之一，大多数需要前交叉韧带重建手术。早在重建后的7-15年，大多数人就会患上膝骨性关节炎，这是成人一生中疼痛、功能障碍和生活质量下降的主要原因。膝关节骨性关节炎的发生发展是一个复杂的过程，是多种因素共同作用的结果，膝关节运动学和动力学改变是其重要影响因素。重建前交叉韧带后，在日常生活活动和高水平活动中观察到膝关节运动学和动力学的改变，并在前交叉韧带重建后持续长达两年。我们的总体研究目标是研究5年后前交叉韧带重建后膝关节运动学和运动学对关节软骨完整性和膝关节力学的作用。第一个目标是确定前交叉韧带重建后的膝关节力学是否稳定，并跟踪到5年后。第二个目的是确定前交叉韧带重建后的膝关节力学是否能预测前交叉韧带重建后5年的软骨完整性。在这项研究中，我们将利用我们先前收集的30个个体的生物力学和临床数据，这些数据是在初次单侧前交叉韧带重建后收集的。在同一队列中，我们将在前交叉韧带重建后的5年内，用磁共振成像和生物力学数据来扩展我们之前收集的数据。三维膝关节运动学和动力学将量化膝关节力学，3-T磁共振成像将用于量化膝关节软骨的形态和成分(T1-Rho和T2松弛时间)特征。这种方法将允许立即检验我们的总体假设，即前交叉韧带重建后膝关节力学在5年后仍然存在，并与关节软骨完整性的测量有关。通过这一建议，我们将建立后交叉韧带重建力学在早期软骨退变中的潜在作用，促进对膝骨性关节炎早期发病机制的基础认识。这项研究的成功完成将使前交叉韧带损伤患者的康复和手术治疗方案得以开发和测试，这些方案可能会更好地恢复膝关节力学，并最终可能缓解早产儿骨性关节炎的发展。

DESCRIPTION (provided by applicant): Premature development of knee osteoarthritis (OA) is recognized with increasing frequency following anterior cruciate ligament (ACL) injuries. ACL injury is one of the most common and debilitating athletic injuries in adolescents and young adults with a majority requiring an ACL reconstruction procedure. As early as 7-15 years following reconstruction, a large majority of individuals develop knee OA, a major cause of pain, functional disability and decline in quality of life throughout the adult life-span. The developmen of knee OA is a complex process resulting from multiple factors of which altered knee kinematics and kinetics are known contributors. Altered knee kinematics and kinetics are observed following ACL reconstruction during activities of daily living as well as during high-leve activities, and persist for as long as two years following ACL reconstruction. Our overall study objective is to investigate the role of knee kinematics and kinematics following ACL reconstruction on articular cartilage integrity and knee mechanics 5 years later. The first Aim wil determine if knee mechanics at post-ACL reconstruction are stable and track to 5 years later. The second Aim will determine if post-ACL reconstruction knee mechanics predict measures of cartilage integrity at 5 years following ACL reconstruction. For this study, we will utilize biomechanical and clinical data from 30 individuals that we previously collected following primary, unilateral ACL reconstruction. We will extend our previously collected data with magnetic resonance imaging and biomechanical data at 5 years post-ACL reconstruction in the same cohort. Three-dimensional knee kinematics and kinetics will quantify knee mechanics and 3-T MR imaging will be used to quantify morphological and compositional (T1-rho and T2 relaxation time) characteristics of knee articular cartilage. This approach will allow for immediat testing of our overall hypothesis that post-ACL reconstruction knee mechanics persist at 5 years later and are associated with measures of articular cartilage integrity. Through this proposal, we will establish the potential role of post-ACL reconstruction mechanics on early cartilage degeneration, advancing fundamental knowledge of the early pathogenesis of knee OA. Successful completion of this study will allow for the development and testing of rehabilitation and surgical treatment options for individuals with ACL injury that may better restore knee mechanics, and ultimately may mitigate development of premature OA.