UT medical student to use grant to develop mathematical model to predict ACL injuries
Jul 10, 2008
More high school and college women athletes suffer knee injuries involving the anterior cruciate ligament (ACL) than do their male counterparts.
Carmen Quatman, a fourth-year MD/PhD student, discussed a computer model of a knee with Dr. Vijay Goel. The two are working on research to learn more about the biomechanics of ACL injuries and to determine why women are more susceptible to ACL tears.
That fact is well-established. What is less clear, however, is how the process occurs and who is most at risk.
Now a fourth-year University of Toledo MD/PhD student has received a $5,000 grant from the American College of Sports Medicine Foundation to further develop a mathematical model to learn more about the biomechanics of ACL injuries and to determine why women are more susceptible to ACL tears that can sideline athletes for up to one year.
Carmen Quatman is working on the study with Dr. Vijay Goel, adjunct professor of orthopedic surgery, the McMaster-Gardner Professor of Orthopedic Bioengineering, and co-director of the Engineering Center for Orthopedic Research Excellence on the Main and Health Science campuses.
The ACL helps keep the knee stable. When overloaded, the ACL ruptures, a problem that hits thousands of men and women, basketball and soccer players especially. Moves like landing from a jump, twisting, suddenly changing directions or rapidly decelerating from a sprint put tremendous stress and torque on the knees of women athletes.
“Understanding non-contact ACL injury mechanisms is an essential step toward the development of efficacious techniques for the prevention, diagnosis and treatment of ACL injuries,” said Quatman, a Cincinnati native and a graduate of Edinboro University of Pennsylvania. “Prevention of even a proportion of these ACL injuries would allow many athletes to receive the health benefits of sports participation and avoid the long-term conditions of disability associated with knee osteoarthritis.”
Part of a multi-center study involving UT and Cincinnati Children’s Hospital Sports Medicine Biodynamics Center, the project is aimed at developing a three-dimensional finite-element — or mathematical — model to learn the precise details of an ACL injury and holds the promise of giving scientists the ability to predict who is at risk, to better calculate stress and force on the ligament, and to guide physicians in their efforts to protect vulnerable athletes.
Their computer modeling involves converting CT and MRI scans of young female athletes into a three-dimensional representation of the anatomy of the knee. Using mechanical properties of knee tissues defined by data obtained from cadavers, the researchers can use complex mathematical algorithms to predict how knee tissues react to certain loading conditions.
A special motion-analysis system then captures sports movements of an athlete and that information is entered into the computer model to help researchers determine which situations put the ACL at high risk for injury. The computer model also can be used to simulate what likely occurs during an injury.
“Specifically, we plan to analyze how the ACL and MCL [medial collateral ligament] loading patterns change relative to external loading conditions,” explained Quatman, who recently received the American Academy of Orthopedic Surgeons’ Ruth Jackson Orthopedic Society Medical Student Scholarship. “Our long-term objective is to use the finite-element model to analyze large population-based motion analysis studies on young female athletes in order to develop algorithms to predict athletes who are at high risk for sustaining ACL injuries.”
Current methods used to study ACL injuries, including in vivo motion-analysis studies that “mimic” specific movements, have shortcomings, according to Quatman.
“Motion-analysis studies are limited to estimating total joint biomechanics and do not allow estimation of tissue-level biomechanics involving ligaments and bones. Also, it is neither ethical nor advisable to apply external loads to a human subject until we cause injury,” she explained. “Developing this computer model will allow researchers to predict how certain knee movements affect the ligaments, cartilage and bones in the knee.”
After Quatman finishes her graduate and medical school studies, she plans to pursue a career in orthopedic surgery and continue to conduct biomechanics and musculosketetal research.