The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee, with female athletes sustaining ACL injuries at a 2-8 fold greater rate compared to male athletes. An ACL injury can be devastating and significantly increases the athlete's risk for osteoarthritis long term. While many advances have been made in terms of surgical and rehabilitation treatments for ACL injured patients, long term outcome studies show that these patients are at a high risk for developing knee osteoarthritis 10-15 years after ACL injury regardless of the treatment. Currently, the mechanism of non-contact ACL injury is not well understood. In order to design successful ACL injury prevention programs and address the high rates of ACL injuries in the female athlete population, a better understanding of the non-contact ACL injury mechanism must be established. Both biomechanical data and video analyses indicate that increased abduction loads in the lower extremities may be associated with increased ACL strain and risk of injury. However, the medial collateral ligament (MCL) is considered to be the primary restraint against abduction stress in the knee joint. Clinicians and biomechanists are unable to explain why ACL ruptures without MCL injuries are significantly more common than combined ACL/MCL injuries. We hypothesize that coupled abduction and anterior knee joint loads near full knee extension will lead to disproportional increases in ACL strain relative to MCL strain and lead to ACL failure loads without concomitant MCL failure loads in female athletes. We propose to use a unique blend of the current methods used to investigate ACL injury mechanisms in order to gain an in depth understanding of knee ligament biomechanics during high knee loading conditions. Specifically, we aim to determine the mechanical responses of the ACL and MCL to loads using cadaveric testing, computer mathematical modeling, and three-dimensional motion analysis. Identifying ACL injury mechanisms may help us develop ACL injury prevention programs that would allow many athletes to receive the health benefits of sports participation and avoid the long term sequelae of disability associated with knee osteoarthritis.

Public Health Relevance

Relevance to Public Health:An anterior cruciate ligament (ACL) injury can be devastating and places an athlete at a high risk of developing osteoarthritis long term. Unfortunately, surgical intervention does not change the odds of developing knee osteoarthritis after injury. We utilize biomechanical methods to identify mechanisms of ACL injury in order to develop effective interventions to prevent ACL injury.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR056259-04
Application #
8284418
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Panagis, James S
Project Start
2009-05-15
Project End
2013-09-15
Budget Start
2012-05-01
Budget End
2013-09-15
Support Year
4
Fiscal Year
2012
Total Cost
$416,997
Indirect Cost
$59,874
Name
Ohio State University
Department
Physiology
Type
Schools of Medicine
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Nagai, Takashi; Schilaty, Nathan D; Strauss, Jeffrey D et al. (2018) Analysis of Lower Extremity Proprioception for Anterior Cruciate Ligament Injury Prevention: Current Opinion. Sports Med 48:1303-1309
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
Nagai, Takashi; Bates, Nathaniel A; Hewett, Timothy E et al. (2018) Effects of localized vibration on knee joint position sense in individuals with anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 55:40-44
Schilaty, Nathan D; Bates, Nathaniel A; Hewett, Timothy E (2018) Relative dearth of 'sex differences' research in sports medicine. J Sci Med Sport 21:440-441
Krill, Matthew L; Nagelli, Christopher; Borchers, James et al. (2018) Effect of Concussions on Lower Extremity Injury Rates at a Division I Collegiate Football Program. Orthop J Sports Med 6:2325967118790552
McPherson, April L; Bates, Nathanial A; Schilaty, Nathan D et al. (2018) Ligament Strain Response Between Lower Extremity Contralateral Pairs During In Vitro Landing Simulation. Orthop J Sports Med 6:2325967118765978
Nesbitt, Rebecca J; Bates, Nathaniel A; Rao, Marepalli B et al. (2018) Effects of Population Variability on Knee Loading During Simulated Human Gait. Ann Biomed Eng 46:284-297
Schilaty, Nathan D; Nagelli, Christopher; Bates, Nathaniel A et al. (2017) Incidence of Second Anterior Cruciate Ligament Tears and Identification of Associated Risk Factors From 2001 to 2010 Using a Geographic Database. Orthop J Sports Med 5:2325967117724196
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
Sugimoto, Dai; Mattacola, Carl G; Bush, Heather M et al. (2017) Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates. J Athl Train 52:58-64

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