Gene expressions dynamics in nerve regeneration after anterior cruciate ligament injury in a rat model
Naohiko KanemuraTakanori KokubunYuri MorishitaKenji MurataY. ShimaharaAya NakajimaYuichiro OkaK. Takayanagi
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Keywords:
Neurofilament
ACL injury
Nerve Injury
ACL injury
Strain (injury)
Ground reaction force
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Abstract Background The Anterior cruciate ligament (ACL) is one of the most easily injured ligaments in the knee. Abnormal femur and knee rotation may lead to ACL injury, while an increased proportion of the lateral femoral condyle is also a potential factor in ACL injury. Therefore, distal femoral torsion (DFT) may be closely related to ACL injury. Thus, this study aims to investigate the associations of DFT with the risk of ACL injury and the severity of the injury. Methods 582 patients who received ACL reconstruction surgery between 2014 and 2019 were examined retrospectively, and 114 patients were selected for analysis. Among them, 32 experienced ACL and anterolateral ligament (ALL) injury (ACL + ALL-injury group), and 32 experienced only ACL injury (only ACL injury group). In addition, 50 patients with similar age and BMI, but without ACL or ALL injury, were selected as the control group. DFT was assessed via the surgical posterior condylar angle (sPCA) on MRI by a blinded researcher. Inter-group differences were assessed via ANOVA. An ROC (Receiver Operating Characteristic) curve was generated to elucidate the ACL injury risk, and to establish the appropriate threshold value. Result The average sPCA was 3.68 ± 1.26° among the ACL + ALL-injury and ACL-injury only patients. Notably, the 3.77 ± 1.15° sPCA among the ACL + ALL-injury patients, and the 3.58 ± 1.37° sPCA among the ACL-injury patients were markedly enhanced, compared to the 2.41 ± 1.48° value in control patients. The ACL + ALL patients displayed an augmented sPCA trend over ACL-alone patients, however, it did not reach significance. Moreover, based on the ROC curve, sPCA > 2.37° was indicative of an enhanced ACL injury risk among the ACL-intact individuals. Conclusion Based on our analysis, augmented sPCA values were intricately linked to enhanced ACL injury risk in non-contact ACL ruptured patients. Nevertheless, its usage as a predictor of ACL injury severity is scarce. The conclusions of this study will likely assist orthopedic surgeons in identifying patients who may benefit from targeted ACL injury prevention.
ACL injury
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ACL injury
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ACL injury
Biomechanics
Contact force
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Introduction: Recent evidence has emerged suggesting that a non-contact anterior cruciate ligament (ACL) tear can result from repetitive submaximal loading of the ligament. In other words, when the intensity of ACL-straining athletic activities is increased too rapidly, microdamage can accumulate in the ligament beyond the rate at which it can be repaired, thereby leading to material fatigue in the ligament and its eventual failure. The objective of this survey-based exploratory study was to retrospectively determine whether the levels of various athletic activities performed by ACL-injured patients significantly changed during the 6 months before injury. Methods: Forty-eight ACL-injured patients completed a survey to characterize their participation in various activities (weightlifting, sport-specific drills, running, jumping, cutting, pivoting/twisting, and decelerating) at three timepoints (1 week, 3 months, 6 months) prior to ACL injury. Activity scores, which summarized the frequency and intensity of each activity, were calculated for each patient at each time interval. A series of linear mixed-effects regression models was used to test whether there was a significant change in levels of the various activities in the 6-month period leading up to ACL injury. Results: Patients who sustained a non-contact ACL injury markedly increased their sport-specific drills activity levels in the time leading up to injury (p = 0.098), while those patients who sustained a contact ACL injury exhibited no change in this activity during the same time period (p = 0.829). Levels of running, jumping, cutting, pivoting/twisting, and decelerating increased for non-contact ACL-injured patients but decreased for contact ACL-injured patients, though not significantly (p values > 0.10). Weightlifting activity significantly decreased leading up to injury among contact ACL-injured patients (p = 0.002). Discussion: We conclude that levels of ACL-straining athletic activities or maneuvers in non-contact ACL-injured patients markedly increased in the 6 months leading up to their injury, providing evidence that changing levels of certain activities or maneuvers may play a role in ACL injury risk. This warrants further investigation of the hypothesis that too rapid an increase in activities or maneuvers known to place large loads on the ACL can cause microdamage to accumulate in the ligament, thereby leading to failure.
ACL injury
Anterolateral ligament
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ACL injury
Vastus medialis
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Human anterior cruciate ligament (ACL) has poor healing ability after injury. The devastating effects of matrix metalloproteinases (MMPs) excess expression are regarded as the main reason. Tissue inhibitor metalloproteinases (TIMPs) may be independent of MMPs inhibition. In this paper, a rat ACL rotating injury apparatus was designed to produce ACL injury. After inducing injury, joint fluids and ACL tissue total proteins were immediately extracted. In addition, ACL tissue was isolated in a culture plate with 1%FBS medium for the ex vivo study. We found MMP-2 in joint fluids increased significantly by 4 folds after ACL injury as a function of time. Ex vivo study showed MMP-2 in the medium and ACL cultured tissue increased significantly respectively to 3 folds and to 6 folds. The joint fluids global MMP increased to 3.5 folds with non-treatment and APMA-treatment in day three. On the gene expression level, the changes in MMP-1 and CD147 have the similar tendency. The ratio of MMP-1/TIMP-1 increased with time after ACL injury. We conclude that MMP-2 increased significantly in the early phase in the joint cavity after ACL injury. The ex vivo study demonstrated the same tendency. Generic MMP Activity Assay (global MMP assay) an dzymography also showed significant increase in MMP activity in joint fluids. These results showed ACL having poor healing ability after injury may not be only due to ACL release of large quantities of MMPs. The important factor may be the alterations in the whole joint cavity's internal environment.
ACL injury
Ex vivo
Matrix (chemical analysis)
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본 연구는 여자 운동선수의 ACL 손상에 관한 많은 과학적 연구들이 발표되었고, 여자 운동선수의 높은 ACL 손상을 일으키는 많은 위험요인이 보고되었지만 ACL 손상을 가장 잘 예측할 수 있는 위험인자는 아직까지 불명확하다고 할 수 있다. 여러 선행연구들을 분석하여 고찰해 본 결과 여자 운동선수의 비접촉성 ACL 손상은 단일한 요인보다는 여러 가지 요인이 복합되어 나타나는 것이다.
또한 심각한 슬관절 손상은 잘 계획된 훈련 프로그램에 의해 발생율을 감소시킬 수 있다. 방향전환, 무릎을 편채 착지, 갑작스런 멈춤(one-step stop)과 같은 활동을 변형함으로써 ACL 손상율을 감소시킬 수 있다. ACL 손상 예방 프로그램은 고유 감각 수용기, 플라이오메트릭(plyometric), 근력강화 훈련, 점핑, 멈추기(stopping) 그리고 방향전환(turning)기술의 개선을 포함하여야 한다. 각 종목별 부상의 원인과 기전 분석하여 부상 방지를 위한 훈련 프로그램이 개발되어 적용되어 진다면 여자 운동선수의 비접촉성 ACL 손상의 발생을 줄이고 예방할 수 있을 것이다.
또한 심각한 슬관절 손상은 잘 계획된 훈련 프로그램에 의해 발생율을 감소시킬 수 있다. 방향전환, 무릎을 편채 착지, 갑작스런 멈춤(one-step stop)과 같은 활동을 변형함으로써 ACL 손상율을 감소시킬 수 있다. ACL 손상 예방 프로그램은 고유 감각 수용기, 플라이오메트릭(plyometric), 근력강화 훈련, 점핑, 멈추기(stopping) 그리고 방향전환(turning)기술의 개선을 포함하여야 한다. 각 종목별 부상의 원인과 기전 분석하여 부상 방지를 위한 훈련 프로그램이 개발되어 적용되어 진다면 여자 운동선수의 비접촉성 ACL 손상의 발생을 줄이고 예방할 수 있을 것이다.
ACL injury
Plyometrics
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Anterior cruciate ligament (ACL) injuries are common in soccer. Understanding ACL loading mechanisms and risk factors for ACL injury is critical for designing effective prevention programs. The purpose of this review is to summarize the relevant literature on ACL loading mechanisms, ACL injury risk factors, and current ACL injury prevention programs for soccer players. Literature has shown that tibial anterior translation due to shear force at the proximal end of tibia is the primary ACL loading mechanism. No evidence has been found showing that knee valgus moment is the primary ACL loading mechanism. ACL loading mechanisms are largely ignored in previous studies on risk factors for ACL injury. Identified risk factors have little connections to ACL loading mechanisms. The results of studies on ACL injury prevention programs for soccer players are inconsistent. Current ACL injury prevention programs for soccer players are clinically ineffective due to low compliance. Future studies are urgently needed to identify risk factors for ACL injury in soccer that are connected to ACL loading mechanisms and have cause-and-effect relationships with injury rate, and to develop new prevention programs to improve compliance.
ACL injury
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ACL injury
Musculoskeletal injury
Meniscus
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