Principal Investigator: Thomas P. Andriacchi, PhD Project Category: Other The goal of this project is to better understand the role of mechanical and biologic factors in the progression of tibiofemoral osteoarthritis (OA). This project builds on the observations that in vivo dynamic loading and biologic factors can result in destabilization of the normal coupling of degradation and synthesis of articular cartilage, and that the pattern of these events is likely to contribute to the substantial variation in patient outcome. Dynamic Loading and Knee OA. The adduction moment during gait has been related to the load on the medial compartment of the knee. Patients with varus gonarthosis and higher than normal adduction moments during gait had a lower probability of a good clinical result following high tibial osteotomy (HTO). In another study the adduction moment was related to the medial-lateral bone density distribution in the proximal tibia. Cartilage Metabolic Markers and Knee OA. Recent studies have suggested that serum levels of hyaluronan (HA) and cartilage oligomeric matrix protein fragments (COMP) are elevated in those with tibiofemoral OA who progress. Cytokines (i.e. IL-1) effective in upregulating HA synthesis and downregulating aggrecan and type II collagen synthesis and matrix repair by chondrocytes in vitro may mediate these metabolic changes in vivo. The Assessment of Outcome in Knee OA. The importance and clinical significance of understanding the factors influencing the variable rate of progression of knee OA has been recognized and supported in a Multipurpose Arthritis and Musculoskeletal Diseases Center Education, Epidemiology, and Health Services Research project (the MAMDC study) at Northwestern University (NU). The proposed study will take advantage of outcome and covariate data from that study. Funding Source: NIH Funding Status: Funded |
