Blowing out a knee can be a pain in more ways than one.
More than half of young women who rupture their anterior cruciate ligament (ACL) develop osteoarthritis (OA) symptoms 10 to 15 years after their injury, despite early treatments like surgery or rehabilitation. And very little is known about the time after recovery, but before developing osteoarthritis.
That’s the knowledge gap doctoral student Allison Ezzat is looking to fill with her thesis, which will examine physical activity and health outcomes in female adolescents one to two years after ACL injury. This is a critical window because the patients are over the acute phase of injury and surgery recovery, as well as being before the traditional onset of OA, Ms Ezzat said. Young women sustain more than twice as many ruptures as male adolescents, making them a high-risk group for OA development, she said.
“Osteoarthritis is a big problem in Canada and can affect individuals at a younger age than many people realize.”
Doctoral student Allison Ezzat
Osteoarthritis is the leading cause of severe chronic pain and disability worldwide, and affects 4.4 million Canadians, of which it is thought at least one million have had a previous joint injury, Ms. Ezzat said. “As yet, there is no evidence to support strategies to prevent this debilitating joint disease.”
Ms. Ezzat’s research will begin to bridge the knowledge gap between acute knee injury in young women and risk for future chronic knee joint disease. Her work will use accelerometers to measure physical activity, as well as interviews with young women who have previously had ACL injury. These interviews would also explore psychological factors such as fear of re-injury, and knee confidence, she said, which could affect whether young women engaged in physical activity which was good for them.
Her preliminary results have shown that people with a previous knee injury had much greater odds of reporting concerns about their knee confidence, or how much they trusted their knee, than those who had never been injured, Ms. Ezzat said. Low rates of physical activity, and obesity, are modifiable risk factors for OA.
Ms. Ezzat said that a reason for so many young women developing OA after ACL rupture could be that many individuals are never fully rehabilitated, and do not regain the necessary strength and neuromuscular control. Or, she says, they stay physically active without proper recovery and then end up doing more damage than good.
Ms. Ezzat said she focused on her thesis topic after working as a physiotherapist, seeing young patients with ACL ruptures and older people who had suffered the injury in the past, and thinking there must be something that could be done.
Ms. Ezzat is co-supervised by Associate Professor Mariana Brussoni and University of Calgary Associate Dean Research Dr. Carolyn Emery. She received scholarship funding from the Canadian Child Health Clinician Scientist Program and BC Children’s Hospital Research Institute.
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