ACL reconstruction can reliably restore knee stability and allow competitive and recreational athletes to return to their sports quickly, during the first year after injury. However, the longer-term risk of post-traumatic arthritis is a significant concen for these patients and their physicians. Meniscus tear and cartilage injury have been associated with increased risk of osteoarthritis in ACL reconstruction patients, but previous investigations have been limited by heterogeneous patient populations, poorly validated outcome measures, and retrospective study designs.
The aims of this proposal are (1) to determine whether differences in meniscus treatment and articular cartilage status at baseline predict radiographic signs of osteoarthritis two years after ACL reconstruction, (2) to evaluate the association between instrumented joint laxity and radiographic signs of OA 2 years after ACL reconstruction, and (3) to explore the relationship between arthroscopic treatment at baseline and MRI meniscus and articular cartilage status two years after ACL reconstruction. Along with achieving these aims, the trainee will pursue a training program that will include a combination of didactic activities as well as focused mentorship that complements the research project. The goals for the program will include the following: (1) learn to effectively manage personnel and resources in the conduct of clinical research, (2) improve study design and grant writing skills, (3) develop expertise in the application of statistical modeling to evaluate predictors of prognosi in orthopaedic outcome studies, in particular as it relates to imaging biomarkers, (4) learn to assess the incidence and progression of osteoarthritis using radiographic and MR imaging, (5) learn and apply the principles of responsible conduct of research, and (6) improve manuscript preparation and presentation skills. This mentored training program and research project will enable the trainee to make the transition to independent researcher.

Public Health Relevance

Anterior cruciate ligament (ACL) reconstruction is the most common major knee ligament procedure performed in the United States, and individuals who sustain ACL injury and undergo surgical reconstruction develop subsequent post-traumatic osteoarthritis. The relationships between physical examination, performance on functional tests, activity level, and radiographic signs of joint degeneration are not completely understood. This project aims to better define these relationships in order to identify potential factors that can b modified in the future to lessen the burden of post traumatic osteoarthritis in this population.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Mentored Patient-Oriented Research Career Development Award (K23)
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Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Washabaugh, Charles H
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Cleveland Clinic Lerner
Schools of Medicine
United States
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Jones, Morgan H; MOON Knee Group; Spindler, Kurt P et al. (2018) Differences in the Lateral Compartment Joint Space Width After Anterior Cruciate Ligament Reconstruction: Data From the MOON Onsite Cohort. Am J Sports Med 46:876-882
Mehta, Nabil; Duryea, Jeffrey; Badger, Gary J et al. (2017) Comparison of 2 Radiographic Techniques for Measurement of Tibiofemoral Joint Space Width. Orthop J Sports Med 5:2325967117728675
Westermann, Robert W; Jones, Morgan; Wasserstein, David et al. (2017) Clinical and radiographic outcomes of meniscus surgery and future targets for biologic intervention: A review of data from the MOON Group. Connect Tissue Res 58:366-372
MacFarlane, L A; Yang, H; Collins, J E et al. (2017) Associations among meniscal damage, meniscal symptoms and knee pain severity. Osteoarthritis Cartilage 25:850-857
Jones, Morgan H; Spindler, Kurt P (2017) Risk factors for radiographic joint space narrowing and patient reported outcomes of post-traumatic osteoarthritis after ACL reconstruction: Data from the MOON cohort. J Orthop Res 35:1366-1374
Stegmeier, Nicole; Oak, Sameer R; O'Rourke, Colin et al. (2017) No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults. Sports Health 9:450-455
Amin, Nirav H; McCullough, Kirk C; Mills, Gavin L et al. (2016) The Impact and Functional Outcomes of Achilles Tendon Pathology in National Basketball Association Players. Clin Res Foot Ankle 4:
Jones, M H; Spindler, K P; Fleming, B C et al. (2015) Meniscus treatment and age associated with narrower radiographic joint space width 2-3 years after ACL reconstruction: data from the MOON onsite cohort. Osteoarthritis Cartilage 23:581-8