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

我们项目的新结果是，我们将确定可以改变的肌肉骨骼生物力学因素是否与患膝关节OA风险增加的个体亚组（那些经历过APM的人）的不利软骨变化有关。这项研究的发现是及时的，具有重要的国际意义，因为人们越来越重视预防OA，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光片的传统方法更快地发现那些有风险的人。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，它们可以通过适当的干预加以修改。例如，静态关节对齐可以通过足部矫形器进行调整[Crenshaw， 2000 #1016]，肌肉无力可以通过力量训练来解决，膝关节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，正式的监督下的术后康复并不是APM术后的常规规定，因为它被认为是一个常规程序。如果我们的研究确定了增加软骨损失的危险因素，那么我们将能够为APM术后的个体制定适当的干预策略。然后，这些干预措施可以通过随机对照试验正式测试其减少不利软骨变化的有效性。特别是，这可能导致当前该患者组的术后临床实践发生变化。最终，这可以降低未来OA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.