A Novel Intervention to Prevent Post-Trauma Osteoarthritis Following Knee Joint Injury
Abstract
The knee is one of the most often injured joints in the body. Involvement in combat heightens the risk of knee injury, especially to soft tissues like the anterior cruciate ligament (ACL) and meniscus. In the field, military personnel are subjected to rigorous physical demands, and actions such as jump landings, vehicle accidents, and sudden directional changes resulting in severe impacts to the knee joint. While this may result in gross soft tissue damages that are treated by surgeons, occult damage to other tissues of the knee are currently not treated. Thus, it is not surprising that studies of civilian patients suffering similar injuries show that regardless of surgical reconstruction after traumatic knee injury, there remains a significant risk of a long-term, chronic disease called post-traumatic osteoarthritis (PTOA). Many researchers have used a rabbit model in which the ACL is surgically cut in the laboratory environment to study the consequences of joint injury. This model, however, does not represent the impact-induced soft tissue injury that is known to occur during a traumatic event. Hence, we have developed a novel impact model to study localized changes in joint tissues following traumatic injury. The proposed research is focused on immediate, targeted treatment of occult knee joint damage resulting from severe knee impaction. In this research, knee impaction will be imposed on anesthetized Flemish Giant rabbits resulting in gross as well as occult soft tissue injuries. The occult soft tissue damage manifests itself in acute death of the cells embedded within the tissues of the knee, i.e., meniscus and cartilage. These cells are critical for maintenance of healthy tissue and thus acute repair of these damaged cells is a likely treatment option. Thus, a novel pharmaceutical treatment will be evaluated for its effectiveness at ameliorating cell death following traumatic injury and thereby helping to arrest further degeneration of joint tissues. In the long term, this treatment will allow these tissues to function more normally in the transfer of physiological loads across the traumatized knee. Ultimately, the aim of this research is to provide improved care in triage situations by offering an immediate, direct, and simple treatment post-trauma that may help prevent the development of or reduce the severity of joint arthritis in Veterans and civilians. This study will take 3 years to complete, and clinically relevant outcomes will be shared with the Department of Defense and the scientific community via peer-reviewed publications and presentations at international orthopaedic conferences. It is likely that this research will add to the current regimen of treatments already in place to treat severe knee injuries and lead to better outcomes in the clinical and military settings. The treatment studied in this project may help mitigate the need for total knee arthroplasties, decrease disability, and significantly reduce levels of chronic joint pain in both active and retired Soldiers.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610735
Entities
People
- Roger Haut
Organizations
- Michigan State University
- United States Army