Grant: Project Grant

The role of subchondral bone in the knee following an acute injury is not well understood, yet there are significant changes in all the joint tissues that lead to a high likelihood of developing post-traumatic osteoarthritis (OA) in the long-term. While much of the focus has been on the degeneration of cartilage, largely because in knee OA cartilage wear is associated with disease severity, it is well known that other tissues in the joint are also affected. Bone, which has been associated with knee pain, is a particularly dynamic tissue in terms of adaptation due to physiological and mechanical stimuli, both of which are present in an acutely injured knee. However, the ability to monitor bone changes has been hampered by a lack of sensitive technology to assess 3D changes, in particular the microarchitectural features that lead to functional changes of the tissue. Our lab has developed a new technique that allows longitudinal assessment of knee bone microarchitecture following an acute knee injury, and this allows unprecedented insight into the adaptive processes. Preliminary work has shown significant changes to subchondral bone microarchitecture that are associated with concurrent cartilage adaptation following a rupture of the anterior cruciate ligament of the knee. Our goal in this study is to establish the time course of bone, ligament and cartilage changes following an acute ligament injury of the knee, both before and after reconstructive surgery. These novel longitudinal data, based on multi-modal imaging techniques, will provide insight into the early tissue changes of a knee injury that are likely associated with the long-term debilitating development of knee OA. This information will form a basis to develop future interventions and improved surgical practices that can lead to better long-term outcomes. Key to our approach is the advanced imaging technologies we have developed to simultaneously measure bone and cartilage in injured patients over time.