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Biomechanical Markers of PTOA after ACL Reconstruction and Meniscal Resection

Award Number: R21AR077371
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/08/2021
PERIOD OF PERFORMANCE END DATE: 08/31/2025

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Biomechanical Markers of PTOA after ACL Reconstruction and Meniscal Resection - Project Summary An estimated 120,000 anterior cruciate ligament (ACL) tears are repaired surgically on an annual basis in the United States. Surgical repair stabilizes the ACL-deficient knee, but a growing body of evidence suggests that surgery does not alter the progression to early-onset osteoarthritis, known as post-traumatic osteoarthritis (PTOA). Patients who undergo anterior cruciate ligament reconstruction (ACLR) are more likely to get PTOA, especially those who sustained a meniscal injury at the same time as their ACL tear. Meniscal resection and removal can have disastrous consequences for patients’ long-term knee joint health. Approximately 21%-48% of patients who had all or part of their meniscus removed during ACLR go on to develop PTOA. Effective treatments for stopping PTOA after meniscal resection have not been conceived because the reasons why the disease develops are not well understood. The theorized mechanism speculates that, despite restoring overall stability, surgical reconstruction of the ACL and resection of the meniscus alter the biomechanics of the knee joint: changing the way cartilage responds to load, shifting the point of contact between tibial and femoral cartilage, increasing the speed at which the tibia and femur bones move past one another during physical activities, and decreasing in the distance between the bones. In turn, sections of cartilage experience unaccustomed loads, and irreversible damage results. Central to this theory is the notion that the bones articulate differently compared to non-surgical knees. While this argument makes sense conceptually, it’s possible that the bones do not articulate differently during physical activity, but instead articular cartilage damage at the time of injury starts a sequence of catabolic events culminating in loss of joint space width—the hallmark outcome of osteoarthritis. The study team members possess the necessary skills, expertise and equipment to support or refute the aforementioned hypothetical framework through direct measurements of biomechanical factors. Specifically, high-speed dual fluoroscopy, an X-ray technique, will measure bone motion with submillimeter and subdegree bias and precision; quantitative magnetic resonance imaging (qMRI) will assess cartilage composition; traditional MRI will quantify three-dimensional cartilage structure. In the current proposal, biomechanical markers for PTOA disease onset and progression will be measured at one and two years after surgery. This longitudinal study will address the following two aims. Aim 1: To improve understanding of PTOA pathogenesis by performing a side-to-side comparative analysis of in-vivo knee mechanics (tibiofemoral cartilage strain and arthrokinematics) in patients one year after ACLR+M. Aim 2: To improve understanding of PTOA pathogenesis by performing an image-based analysis of longitudinal changes in cartilage after ACLR+M. Completion of the aims in this proposal will generate new and impactful insights into PTOA’s accelerated timeline in ACLR+M patients by improving our understanding of the initial events associated with the onset and early progression to PTOA.


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 = -$5 )
2026	2022	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT STREET	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	12/16/2025	NON-COMPETING CONTINUATION	-$5
														Subtotal = -$5

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT STREET	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	12/20/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT STREET	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	12/20/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $259,265 )
2022	2022	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT ST	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	2/3/2022	NON-COMPETING CONTINUATION	$235,695
2022	2022	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT ST	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	2	5/25/2022	NON-COMPETING CONTINUATION	$23,570
														Subtotal = $259,265

Issue Date FY: 2021 ( Subtotal = $261,884 )
2021	2021	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT ST	BURLINGTON	VT	05405	CHITTENDEN	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	2/8/2021	NEW	$261,884
														Subtotal = $261,884

Grand Total All Awards = $521,144

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Biomechanical Markers of PTOA after ACL Reconstruction and Meniscal Resection

Award Number: R21AR077371

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/08/2021

PERIOD OF PERFORMANCE END DATE: 08/31/2025

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