It is now widely recognized that gender-based differences can play a major role in the predisposition to disease and injury, yet this remains an understudied phenomenon. Adolescent females who participate in pivoting and jumping sports suffer anterior cruciate ligament (ACL) injury at a 4 to 6-fold greater rate than adolescent males participating in the same sports. Since the passage of Title IX of The Educational Assistance Act, male participation at the high school level has increased less than 3 percent (from 3.7 to 3.8 million), while female participation has increased 800 percent, roughly doubling every 10 years (from 0.3 to 2.7 million). This geometric growth in participation, coupled with the 4 to 6-fold higher injury rate, has been accompanied by an alarming increase in the number of ACL injuries in female athletes. The reason(s) for this ACL injury disparity remain(s) obscure. Prior to puberty, male and female injury risk is more or less equal. Our long-term objectives are to determine how female athletes become more susceptible to non-contact ACL injury, prospectively identify those female athletes who are more susceptible to injury and to determine the underlying mechanistic cause(s) of increased risk at the biomechanical and biochemical levels. Towards these goals, we propose to test the central hypothesis that the biomechanical changes that accompany puberty, including increased height, body segment length and weight, in the absence of the neuromuscular performance spurt that males demonstrate during puberty may lead to biomechanical-neuromuscular imbalances that result in poor dynamic knee stability and high knee injury risk in many female athletes.
SPECIFIC AIM 1 will determine if the biomechanical changes that accompany puberty underlie the decreased dynamic knee stability in female athletes.
SPECIFIC AIM 2 will determine if specific neuromuscular measures of dynamic knee stability can predict ACL injury risk. These data should provide a foundation for approaching both the mechanistic questions underlying risk disparity, as well as increasing our ability to direct high-risk athletes into appropriate neuromuscular training programs ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
3R01AR049735-01A2S1
Application #
7074482
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Panagis, James S
Project Start
2004-09-21
Project End
2009-08-31
Budget Start
2005-03-01
Budget End
2005-08-31
Support Year
1
Fiscal Year
2005
Total Cost
$25,454
Indirect Cost
Name
Children's Hospital Med Ctr (Cincinnati)
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Bates, Nathaniel A; Nesbitt, Rebecca J; Shearn, Jason T et al. (2018) The influence of internal and external tibial rotation offsets on knee joint and ligament biomechanics during simulated athletic tasks. Clin Biomech (Bristol, Avon) 52:109-116
Bates, Nathaniel A; Schilaty, Nathan D; Nagelli, Christopher V et al. (2017) Novel mechanical impact simulator designed to generate clinically relevant anterior cruciate ligament ruptures. Clin Biomech (Bristol, Avon) 44:36-44
Bates, Nathaniel A; McPherson, April L; Nesbitt, Rebecca J et al. (2017) Robotic simulation of identical athletic-task kinematics on cadaveric limbs exhibits a lack of differences in knee mechanics between contralateral pairs. J Biomech 53:36-44
Bates, Nathaniel A; Nesbitt, Rebecca J; Shearn, Jason T et al. (2017) Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro. Clin Orthop Relat Res 475:2385-2396
Nagelli, Christopher V; Hewett, Timothy E (2017) Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations. Sports Med 47:221-232
Willigenburg, Nienke; Hewett, Timothy E (2017) Performance on the Functional Movement Screen Is Related to Hop Performance But Not to Hip and Knee Strength in Collegiate Football Players. Clin J Sport Med 27:119-126
Myer, Gregory D; Barber Foss, Kim D; Gupta, Resmi et al. (2016) Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24:653-60
Panos, Joseph A; Hoffman, Joshua T; Wordeman, Samuel C et al. (2016) Medio-lateral knee fluency in anterior cruciate ligament-injured athletes during dynamic movement trials. Clin Biomech (Bristol, Avon) 33:7-12
Zwolski, Christin; Schmitt, Laura C; Thomas, Staci et al. (2016) The Utility of Limb Symmetry Indices in Return-to-Sport Assessment in Patients With Bilateral Anterior Cruciate Ligament Reconstruction. Am J Sports Med 44:2030-8
Bates, Nathaniel A; Nesbitt, Rebecca J; Shearn, Jason T et al. (2016) Sex-based differences in knee ligament biomechanics during robotically simulated athletic tasks. J Biomech 49:1429-1436

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