In-vivo ACL Tension

描述（由申请人提供）：韧带断裂，如前交叉韧带断裂，是膝关节常见的损伤。虽然手术治疗可以理想地预防退行性改变和功能残疾，但据报道，在ACL重建后，高达38%的患者出现了关节退行性变。手术修复的不可预测的结果反映了目前对重建韧带的体内生物力学知识的不足。本研究项目旨在使用非侵入性成像技术测量负重屈曲时体内ACL张力。新开发的双正交透视成像和基于MR图像的三维计算机建模技术将用于定量确定膝关节屈曲期间各种负重条件下ACL的体内伸长。确定的ACL体内伸长将与ACL的力-伸长曲线相结合，以确定在特定负重条件下的ACL体内张力。严格的验证也将进行，以确保前交叉韧带的力-伸长估计是准确的。这项研究提出了一种创新的方法来测量膝关节韧带的体内张力。活体前交叉韧带张力的数据将为理解前交叉韧带的生物力学作用提供基础知识。这些数据可以作为开发优化的手术前交叉韧带重建技术的定量指南，再现体内生物力学，从而恢复正常的膝关节功能并预防退行性关节炎。在这个项目中建立的方法将包括体内膝关节运动学的精确测量和体内ACL张力的间接测量。这些先进的成像和3D建模技术将为研究所有膝关节韧带的体内功能作用和开发适当的手术治疗这些软组织损伤提供宝贵的见解。这种方法可以很容易地扩展到其他关节（如脊柱、肩膀、手腕和脚踝）软组织损伤的研究和优化治疗。

DESCRIPTION (provided by applicant): Ligament ruptures, such as to the ACL, are common injuries of the knee. While surgical treatment would ideally prevent degenerative changes and functional disability, joint degeneration has been reported in up to 38% of patients after ACL reconstruction. The unpredictable outcome of operative repair reflects a deficiency in the current knowledge of in-vivo biomechanics of the reconstructed ligaments. This research project is designed to measure in-vivo ACL tension during weight-bearing flexion using a non-invasive imaging technique. Newly developed dual-orthogonal fluoroscopic imaging and MR image- based 3D computer modeling techniques will be used to quantitatively determine in-vivo elongation of the ACL under various weight-bearing conditions during knee flexion. The determined in-vivo ACL elongation will be combined with force-elongation curves of the ACL to determine in-vivo ACL tension under specific weight- bearing conditions. A rigorous validation will also be performed in order to ensure that the ACL force- elongation estimates are accurate. This investigation presents an innovative methodology for measuring in- vivo tension of the knee ligaments. The data on in-vivo ACL tension will provide fundamental knowledge for understanding the biomechanical role of the ACL. The data can be used as quantitative guidelines for developing optimzed surgical ACL reconstruction techniques that reproduce in-vivo biomechanics and, hence, restore normal knee function and prevent degenerative arthritis. The methodology established in this project will include an accurate measurement of in-vivo knee kinematics and an indirect measurement of in-vivo ACL tension. These advanced imaging and 3D modeling techniques will provide invaluable insight towards the investigation of in-vivo functional roles of all knee ligaments and the development of appropriate surgical treatments for these soft tissue injuries. This methodology can be readily extended to investigate and optimize the treatment of soft tissue injures of other articular joints such as the spine, shoulder, wrist and ankle.