Anterior cruciate ligament (ACL) injury creates considerable disability and predisposes the knee to the early onset of osteoarthritis. This is a concern because the past two decades has seen an increased participation of women in sports and with this has come a concomitant increase in ACL injuries. The incidence rate of ACL tears is 2 to 9 times greater amongst females in comparison to males;however, there is limited information with regard to the demographic, injury history, hormonal history, anatomic, neuromuscular, and environmental variables that individually or collectively contribute to the risk of suffering an ACL injury. Most of what is known has come from risk factor studies that have focused on selected variables in isolation (e.g. femoral intra-condylar notch width, A-P knee laxity, or phase of menstrual cycle) and consequently it is not surprising that a comprehensive ACL injury risk model has not been established. Our prior research has revealed that the risk model for ACL injury is probably different for females compared to males and this serves as the rational for our investigation, the objective of which is to find the unique combination of risk factors that identify females and males at increased risk of suffering an ACL injury. The hypothesis of our study is: A combination of demographic, injury history, hormonal history, anatomic, neuromuscular, and environmental variables can be used to identify females at increased risk of non-contact ACL trauma, and that a separate combination of these variables can be used to identify males at increased risk of ACL trauma. Initially, we will establish that examiners can measure the potential risk factors in a reliable manner. We will assemble a cohort of collegiate and pre-collegiate athletes and follow them to prospectively accrue ACL injury cases. We will then perform a nested case-control study to identify risk factors for ACL injury. Three controls for each injury case will selected at the time of injury from among teammates who have not been injured at or prior to that time. For subjects that suffer an ACL tear, the potential risk factors that are not modified by the injury will be measured from the injured limb while the factors that are modified by the injury will be measured from the contra-lateral, normal, limb and used to represent the pre-injury condition of the ACL-deficient limb. The same measurements will be obtained on the matched controls. This investigation is significant because it will determine the putative risk factors that identify females and males at increased risk for ACL injury and allow future intervention studies that reduce the incidence of this debilitating injury.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR050421-04
Application #
7846836
Study Section
Special Emphasis Panel (ZRG1-MOSS-F (02))
Program Officer
Panagis, James S
Project Start
2007-09-07
Project End
2013-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
4
Fiscal Year
2010
Total Cost
$1
Indirect Cost
Name
University of Vermont & St Agric College
Department
Orthopedics
Type
Schools of Medicine
DUNS #
066811191
City
Burlington
State
VT
Country
United States
Zip Code
05405
Carter, Josh C; Sturnick, Daniel R; Vacek, Pamela M et al. (2017) Relationship between geometry of the extensor mechanism of the knee and risk of anterior cruciate ligament injury. J Orthop Res 35:965-973
Tourville, Timothy W; Shultz, Sandra J; Vacek, Pamela M et al. (2016) Evaluation of an Algorithm to Predict Menstrual-Cycle Phase at the Time of Injury. J Athl Train 51:47-56
Vacek, Pamela M; Slauterbeck, James R; Tourville, Timothy W et al. (2016) Multivariate Analysis of the Risk Factors for First-Time Noncontact ACL Injury in High School and College Athletes: A Prospective Cohort Study With a Nested, Matched Case-Control Analysis. Am J Sports Med 44:1492-501
Levins, James G; Sturnick, Daniel R; Argentieri, Erin C et al. (2016) Geometric Risk Factors Associated With Noncontact Anterior Cruciate Ligament Graft Rupture. Am J Sports Med 44:2537-2545
Sturnick, Daniel R; Vacek, Pamela M; DeSarno, Michael J et al. (2015) Combined anatomic factors predicting risk of anterior cruciate ligament injury for males and females. Am J Sports Med 43:839-47
Argentieri, E C; Sturnick, D R; DeSarno, M J et al. (2014) Changes to the articular cartilage thickness profile of the tibia following anterior cruciate ligament injury. Osteoarthritis Cartilage 22:1453-60
Sturnick, Daniel R; Argentieri, Erin C; Vacek, Pamela M et al. (2014) A decreased volume of the medial tibial spine is associated with an increased risk of suffering an anterior cruciate ligament injury for males but not females. J Orthop Res 32:1451-7
Beynnon, Bruce D; Hall, John S; Sturnick, Daniel R et al. (2014) Increased slope of the lateral tibial plateau subchondral bone is associated with greater risk of noncontact ACL injury in females but not in males: a prospective cohort study with a nested, matched case-control analysis. Am J Sports Med 42:1039-48
Whitney, Darryl C; Sturnick, Daniel R; Vacek, Pamela M et al. (2014) Relationship Between the Risk of Suffering a First-Time Noncontact ACL Injury and Geometry of the Femoral Notch and ACL: A Prospective Cohort Study With a Nested Case-Control Analysis. Am J Sports Med 42:1796-805
Sturnick, Daniel R; Van Gorder, Robert; Vacek, Pamela M et al. (2014) Tibial articular cartilage and meniscus geometries combine to influence female risk of anterior cruciate ligament injury. J Orthop Res 32:1487-94

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