Sports Medicine

Theoretical and correlation data indicate that abnormal patterns of frontal plane knee tracking and knee flexion angle are important factors in the development of overuse injuries in cycling. Currently, bicycle “fitters” typically rely on visual assessments to apply current theories. However, practitioners are limited by a lack of prospective data, an unknown applicability to the field setting and unvalidated methods that are subjective and experience dependent. The current gold standard for motion analysis, 3D video motion, is largely limited to use in resource rich laboratory settings, and the complex multivariate data can still be difficult to interpret. Here we propose a novel to cycling method of relative accelerometry, employing triaxial accelerometers and functional principal component analysis (fPCA), as a valid cost effective means capable of discriminating between common bicycle fit conditions. Procedure: Ten to 20 experienced competitive subjects age 13 and older, with a good bike fit, and free of biomechanic dysfunction, as determined by the survey and physical assessment, will undergo motion analysis while cycling on a stationary trainer in each one of six randomized fit conditions including current fit, standardized fit, high seat, low seat, varus cleat wedge and valgus cleat wedge. Trials will be recorded simultaneously by manual rating, 2D and 3D video, foot-bed pressure sensors, and triaxial accelerometers.

Physical activity in adults improves cardiovascular health. However, less is known about the patterns of physical activity in early childhood and their effect on cardiovascular health. In this study, we propose analyses on an existing dataset from a completed Cincinnati Children’s prospective cohort study. (Study ID: 99-3-10) These analyses will be used to test hypotheses regarding physical activity patterns in early childhood and their effect on cardiovascular disease risk factors. The risks to subjects are minimal, and there are no direct benefits to the subjects. Consent will be waived due to the minimal risk to subjects and the relative burden placed by obtaining consent. The study data, containing the PHI of the subjects, will be handled securely.

The major goals of this project are to determine how female athletes become more susceptible to non-contact ACL injury, prospectively identify those female athletes who are more susceptible to injury and to determine the underlying mechanistic cause(s) of increased risk at the biomechanical and biochemical levels and to optimize the effectiveness of treatments designed to prevent ACL injuries.

Description: Both biomechanical data and video analyses indicate that increased abduction loads in the lower extremities may be associated with increased ACL strain and risk of injury. However, the medial collateral ligament (MCL) is considered to be the primary restraint against abduction stress in the knee joint. We aim to determine the mechanical responses of the ACL and MCL to loads using a unique blend of cadaveric testing, computer mathematical modeling, and three-dimensional motion analysis to gain an in-depth understanding of knee ligament biomechanics during high knee loading conditions. Identifying ACL injury mechanisms may help us develop ACL injury prevention programs that would allow many athletes to receive the health benefits of sports participation and avoid the long-term sequelae of disability associated with knee osteoarthritis.

Through the studies in our original application, we observed performance deficits and altered movement patterns in athletes following ACL reconstruction, even after these athletes had returned to high-level sports activities. Further, we identified quadriceps weakness as a significant predictor of performance deficits and altered knee mechanics. This application represents the next logical step in pursuit of our goal to understand mechanisms associated with abnormal knee mechanics and decreased functional performance in athletes with ACL reconstruction. The findings of the proposed study will ensure progression toward the understanding of the mechanisms that contribute to articular cartilage damage. Specifically, the outcomes of the proposed study will provide prospective, longitudinal information regarding the effect of quadriceps strength deficits on knee joint mechanics and functional performance of athletes with ACL reconstruction.

The incidence of anterior cruciate ligament (ACL) injury following ACL reconstruction (ACLR) may be 10 times greater than initial risk. Factors that predict a second ACL injury have not been identified. As a result, impairments that increase risk of future injury may persist in athletes returning to sport following ACLR. The purpose is to determine the incidence of subsequent ACL injury following ACLR and identify modifiable factors predictive of a second ACL injury.

During weight bearing, the lateral side of the joint may bear much of the forces across the joint. The lateral meniscus has been shown to bear much of the weight when loaded. It has been suggested that complete meniscectomy could have a direct impact on contact stresses and therefore has an effect of the overall function of the knee joint. It has also been suggested that removal of portions of the menisci increases the possibility of degenerative changes of the knee. Chatain et al. stated that subjective and clinical results of the medial vs. lateral partial meniscectomy were similar, but that radiological results were much worse for the lateral partial meniscectomy.  We believe one reason for the changes in the radiographs is because of the changes in the biomechanics and that specifically the valgus moment and quadriceps moment at the knee will decrease with a radial meniscus tear.

While reviewing the literature, there seems to be no published studies on isolated radial lateral meniscus tears in the athlete between the ages of 8-45. The objective of this study is to determine if there are any measurable changes in gait biomechanics in athletes with isolated radial lateral meniscus tears. Another purpose to this study is to determine if there are biomechanical changes in landing mechanics straight forward and medial/laterally from a small height. A total of 30  to 50 subjects and age matched controls will participate in data collection. Subjects undergoing meniscectomy for isolated radial lateral meniscus tears will be tested preoperatively and at three months following surgery. Participants will be assessed through biomechanical analysis using a motion analysis system. Functional activities being assessed include normal walking, dropping off a box landing on both feet facing straight ahead, and dropping off a box landing on a single leg both medially and laterally for each leg. Data collection for all participants will take approximately eight months.

Purpose of study: The proposed study is a retrospective medical chart and magnetic resonance imaging (MRI) review of patients who presented with bone bruising in the knee joint as a result of anterior cruciate ligament (ACL) injury. Bone bruises are thought to be a static representation of the trauma that occurred at the time of injury, and thus the pattern of bruising may provide clues about the mechanism of ACL rupture. In an attempt to gain further insight into the possible correlation between gender and ACL injury mechanisms, we want to determine if sex-specific differences exist in the prevalence, location and intensity of bone bruising associated with ACL tears in a pediatric population.

Background and significance: The ACL is one of the most commonly injured ligaments of the knee. Interestingly, females are two to eight times more likely to tear their ACL than males (1). In light of this fact and other recent research, it has been suggested that ACL injury mechanisms may be sex-specific, meaning that one gender might be more susceptible to a given mechanism of injury than the other (2). However, more research is needed to elucidate the respective mechanistic differences between male and female ACL injuries. One possible method for understanding ACL injury mechanisms is to investigate the occurrence and severity of concomitant injuries, such as bone bruises. Prior studies have shown that more than 80 percent of patients diagnosed with ACL tears present with at least one associated bone bruise (3). A bone bruise is defined as an area of hemorrhage or edema secondary to microfractures of the trabecular bone. These lesions are thought to be caused by a direct blow to the bone or compressive forces of adjacent bones impacting one another. Although radiographically occult, these bruises are easily visualized as signal intensity abnormalities on MRI. Researchers have successfully used bone bruise patterns to uncover details about the mechanism of ACL injury (4), but very few studies have examined the relationship between bone bruising and gender.

Participation in running ranks as one of the most common sports activities. However, overuse injuries are common and may have serious negative impact on the runner. Stress fractures constitute a specific type of debilitating overuse injury that has been shown to occur often in recreational and competitive runners. Risk factors that predispose an athlete to stress fractures must be identified for successful prevention. Foot type, lower extremity alignment and altered gait are interrelated risk factors that may impact bone loading through gait mechanics. The focus of this project is on how multiple factors may impact gait mechanics that lead to a stress reaction and injury through bone loading. Specifically we propose to determine the effects of foot function and structure on lower extremity injury and mechanics.

Participation in running ranks as one of the most common sports activities. However, overuse injuries are common and may have serious negative impact on the runner. Stress fractures constitute a specific type of debilitating overuse injury that has been shown to occur often in recreational and competitive runners. Risk factors that predispose an athlete to stress fractures must be identified for successful prevention. Foot type, lower extremity alignment and altered gait are interrelated risk factors that may impact bone loading through gait mechanics. The focus of this project is on how multiple factors may impact gait mechanics that lead to a stress reaction and injury through bone loading. Specifically we propose to determine the effects of foot function and structure on lower extremity injury and mechanics.