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软骨寡聚基质蛋白对机械刺激的反应与前交叉韧带重建个体的动态负荷相关。

Cartilage oligomeric matrix protein responses to a mechanical stimulus associate with ambulatory loading in individuals with anterior cruciate ligament reconstruction.

作者信息

Erhart-Hledik Jennifer C, Titchenal Matthew R, Migliore Eleonora, Asay Jessica L, Andriacchi Thomas P, Chu Constance R

机构信息

Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.

Palo Alto Veterans Hospital, Palo Alto, California, USA.

出版信息

J Orthop Res. 2022 Apr;40(4):791-798. doi: 10.1002/jor.25121. Epub 2021 Jul 12.

Abstract

Mechanical factors have been implicated in the development of osteoarthritis after anterior cruciate ligament (ACL) reconstruction. This study tested for associations between ambulatory joint loading (total joint moment [TJM] and vertical ground reaction force [vGRF]) and changes in serum levels of cartilage oligomeric matrix protein (COMP) in response to a mechanical stimulus (30-min walk) in individuals with ACL reconstruction. Twenty-five subjects (mean age: 34.5 ± 9.8 years; 2.2 ± 0.2 years post-surgery) with primary unilateral ACL reconstruction underwent gait analysis for assessment of peak vGRF and TJM first (TJM1) and second (TJM2) peaks. Serum COMP concentrations were measured by enzyme-linked immunosorbent assay immediately before, 3.5 h, and 5.5 h after a 30-min walk. Pearson correlation coefficients and backward stepwise multiple linear regression analysis, with adjustments for age, sex, body mass index, and between-limb speed difference, assessed associations between changes in COMP and between-limb differences in joint loading parameters. Greater TJM1 (R = 0.542, p = 0.005), TJM2 (R = 0.460, p = 0.021), and vGRF (R = 0.577, p = 0.003) in the ACL-reconstructed limb as compared to the contralateral limb were associated with higher COMP values 3.5 h following the 30-min walk. Change in COMP at 5.5 h became a significant predictor of the between-limb difference in TJM1 and vGRF in multivariate analyses after accounting for the between-limb speed difference. These results demonstrate that higher TJM and vGRF in the ACLR limb as compared to the contralateral limb are associated with higher relative COMP levels 3.5 and 5.5 h after a 30-min walk. Future work should investigate the effect of therapies to alter joint loading on the biological response in individuals after ACL reconstruction.

摘要

机械因素被认为与前交叉韧带(ACL)重建术后骨关节炎的发生有关。本研究测试了ACL重建个体在接受机械刺激(30分钟步行)后,动态关节负荷(总关节力矩[TJM]和垂直地面反作用力[vGRF])与软骨寡聚基质蛋白(COMP)血清水平变化之间的关联。25名接受原发性单侧ACL重建的受试者(平均年龄:34.5±9.8岁;术后2.2±0.2年)首先接受步态分析以评估峰值vGRF和TJM的第一(TJM1)和第二(TJM2)峰值。在30分钟步行前、步行后3.5小时和5.5小时,通过酶联免疫吸附测定法测量血清COMP浓度。采用Pearson相关系数和向后逐步多元线性回归分析,并对年龄、性别、体重指数和肢体间速度差异进行校正,以评估COMP变化与关节负荷参数肢体间差异之间的关联。与对侧肢体相比,ACL重建肢体中更高的TJM1(R = 0.542,p = 0.005)、TJM2(R = 0.460,p = 0.021)和vGRF(R = 0.577,p = 0.003)与30分钟步行后3.5小时更高的COMP值相关。在考虑肢体间速度差异后,5.5小时时COMP的变化在多变量分析中成为TJM1和vGRF肢体间差异的显著预测因子。这些结果表明,与对侧肢体相比,ACL重建肢体中更高的TJM和vGRF与30分钟步行后3.5小时和5.5小时更高的相对COMP水平相关。未来的工作应研究改变关节负荷的治疗方法对ACL重建个体生物学反应的影响。

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