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Knee Function after ACL Injury - genetic predisposition, clinical and laboratory assessment and long term consequences.

Rupture of the anterior cruciate (ACL) ligament in the knee is common, most often in young people performing sport. The injury results in instability, weakness and pain/osteoarthritis. Treatment is physiotherapy with or without surgery, but it is still not known what is best in the short or long term.

The project is a follow up of more than hundred persons who suffered an ACL 17-23 years ago, of whom half had surgery. The persons are examined clinically, with x-rays, by interviews and they perform physical functional tests in a movement laboratory. The results are analyzed with regard to treatment and development of osteoarthritis. We also develop new measures of knee function and investigate genetical predisposition for ACL injury and osteoarthritis.

Project overview

Project period

2015-01-01 2018-12-31

External funding

The Swedish Research Council, 2011-2017: SEK 6,400,000
VLL spjutspetsmedel, 2014-2016: SEK 2,700,000
Centrum för idrottsforskning, 2013-2014: SEK 154,000
Reumatikerförbundet, 2014: SEK 200,000
VLL ALF medel, 2016-2017: SEK 600,000

Subject

Ortopedi, Sjukgymnastik/fysioterapi

Head of research

Project description

Injury of the anterior cruciate ligament (ACL) in the knee is common, and treated with physiotherapy with or without surgery. There is still no evidence which is the best option, with respect to long term function and the risk of developing osteoarthritis (OA). This is partly due to a lack of gold standard on how to assess knee function and our lack of understanding of possible hereditary risk factors. Our aims are 1) to comprehensively evaluate knee function after ACL injury regarding the long term consequences and impact on daily life, and how the treatment given initially relates to the outcome; 2) to provide new and improved clinical knee assessment, as well as protocols for laboratory based movement assessment targeting the functional control of the knee, which do not currently exist; 3) explore genetic predisposition with respect to ligament tissue structure, development of OA, and physical risk taking, all extremely novel. We study a unique cohort with two groups who had ACL injury on average 23 (17-31) years ago: one group had physiotherapy and surgery and the other physiotherapy alone, and compare to healthy controls. Significance: There is no equivalent study with extensive data collection including movement analysis so long after injury. We strive to meet the highlighted need for improved physiotherapy tools to guide and evaluate treatment, tailored to the individual. The genetic approach may shed a completely new light on injury prevention.