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Walk this Way: Physical Activity and Walking Biomechanics Lead to Early Knee OA Symptoms and Ultrasound-Detected Structural Pathology after ACL Reconstruction

Award Number: K01AR081389
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 08/01/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2027

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Walk this Way: Physical Activity and Walking Biomechanics Lead to Early Knee OA Symptoms and Ultrasound-Detected Structural Pathology after ACL Reconstruction - PROJECT SUMMARY About 250,000 anterior cruciate ligament (ACL) injuries occur annually in the United States and are primarily treated with a surgical reconstruction (ACLR). However, for at least 1 in 3 young adults with an ACLR, the injury and surgery are pivotal life events that lead to chronic pain, diminished long-term quality of life, and an increased risk for osteoarthritis (OA). The 1st year post-ACLR is critical to a patient’s long-term outcomes as there is evidence that levels of pain and quality of life experienced at 1 year post-ACLR will remain unchanged for up to 10 years. Additionally, at 1 year post-ACLR, ~33% of young adults present with knee structural pathologies. Unfortunately, there are no evidence-based strategies to identify people during the 1st year post-ACLR who are at risk for chronic symptoms or structural pathology. Hence, we cannot identify susceptible populations and lack critical insights into which modifiable risk factors could decrease their risk and prevent lifelong disability. Potentially modifiable risk factors that are common throughout the 1st year post-ACLR are alterations in walking biomechanics and insufficient levels of physical activity. Since poor symptoms and pre-radiographic structural pathology are risk factors for the development of knee OA, understanding modifiable risk factors that relate to poor symptomatic and structural outcomes during the 1st year post-ACLR is needed for future studies to identify therapies that prevent OA. The objective of this study is to determine how longitudinal changes in PA and walking biomechanics assessed at 3, 6, 9, and 12 months post-ACLR relate to poor symptomatic or structural outcomes during the 1st year post-ACLR. This will be the first study that applies the following outcomes to young adults at multiple visits during the 1st year post-ACLR: 1) classification criteria for early OA symptoms, 2) clinically accessible whole-knee ultrasound scoring system to detect multiple structural pathologies. PA will be assessed with research-grade accelerometers to quantify steps per day and weekly minutes of moderate to vigorous PA during a 7-day period following each study visit. Walking biomechanics will be assessed in a motion capture laboratory to quantify vertical ground reaction force and internal knee adduction moment. My central hypothesis is that participants with a moderate change in PA and walking biomechanics post-ACLR will be less likely to have poor symptomatic and structural outcomes during the 1st year when compared to people with a rapid increase or no change in PA and walking biomechanics. The expected outcome of this work is to identify: 1) at- risk patients post-ACLR who are the ideal participants for clinical trials aimed at preventing poor symptomatic and structural outcomes, and 2) when PA or walking biomechanics need to be targeted during the 1st year post- ACLR. This proposal will also provide the PI with the training and mentoring to develop a novel skill set in whole- knee ultrasound imaging, device-based PA monitoring, longitudinal data analyses, and clinical trial design. This training and mentoring will directly lead to an R34 clinical trial planning grant to develop a clinical trial using gait retraining or PA promotion to prevent poor symptomatic or structural outcomes in high-risk patients post-ACLR.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $127,189 )
2026	2026	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 360	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	6/10/2026	NON-COMPETING CONTINUATION	$127,189
														Subtotal = $127,189

Issue Date FY: 2025 ( Subtotal = $127,224 )
2025	2025	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	6/4/2025	NON-COMPETING CONTINUATION	$127,224
														Subtotal = $127,224

Issue Date FY: 2024 ( Subtotal = $127,126 )
2024	2024	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	5/17/2024	NON-COMPETING CONTINUATION	$127,126
														Subtotal = $127,126

Issue Date FY: 2023 ( Subtotal = $180,084 )
2023	2023	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	5/2/2023	NON-COMPETING CONTINUATION	$127,194
2023	2023	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	2	5/3/2023	SUPPLEMENT FOR EXPANSION	$52,890
														Subtotal = $180,084

Issue Date FY: 2022 ( Subtotal = $127,221 )
2022	2022	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	7/22/2022	NEW	$127,221
														Subtotal = $127,221

Grand Total All Awards = $688,844

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Walk this Way: Physical Activity and Walking Biomechanics Lead to Early Knee OA Symptoms and Ultrasound-Detected Structural Pathology after ACL Reconstruction

Award Number: K01AR081389

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 08/01/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2027

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