Preventing osteoarthritis after ACL injury

September 29, 2015 | Dr. Steven Boyd

Dr. Steven BoydThe Issue

Suffering an acute ligament injury – like an ACL tear – puts you at high risk of osteoarthritis in the future. Previous studies have focused on cartilage damage, but evidence is mounting that bone may react more quickly (and negatively) to such an injury.

Dr. Steven Boyd began his career studying how bone changes with disease or age, mostly targeting osteoporosis.  But when the avid skier crashed at Lake Louise and tore his ACL, he wondered what would happen to his knee, and started to closely monitor it.

He knows that an ACL injury can change your life and curtail an active lifestyle. People are forced to decide whether to manage through exercise and physiotherapy or undergo reconstructive surgery. While the latter helps mobility in the short term, it also increases your arthritis risk over the long term. 

The Study

Using brand new technology, Dr. Boyd’s team will investigate what happens to the knee in the first year following an ACL injury. The answers could lead to treatments that are given – most crucially – early after such joint trauma in order to prevent osteoarthritis. 

At the University of Calgary, they were able to obtain the world’s first high-resolution CT scanner called “XtremeCT2.” This machine scans more of the body, and Dr. Boyd discovered he could scan the knee at a resolution that was never before possible. This remarkable imaging equipment can scan knees in fine detail – and they will use it to truly understand post-injury changes. 

They will recruit people who have recently torn their ACL. They will use the XtremeCT to scan their knee then, again at four months, and again at eight months. At the same time they will use an MRI scanner to assess the cartilage. Dr. Boyd said he expects to find loss of bone strength and, at four months, the entire dynamic of the joint altered.

The Impact

The goal is to see what happens to a knee in the early goings after an injury. From this comes the ability to use interventions early to stop the rapid changes in bone that lead to osteoarthritis. We could potentially use existing drugs to prevent osteoarthritis from settling into an injured knee. 

“With post-traumatic osteoarthritis, it gives us a unique opportunity to study what’s going on early,” he said. “We will know in the future if it is effective to treat someone after they’ve had an injury.” 

The Researcher

Dr. Steven Boyd is a professor at the University of Calgary’s Cumming School of Medicine and holds a joint position at the Schulich School of Engineering and Faculty of Kinesiology. He principally studies what changes to tissues occur following a joint injury or disease.

“The Arthritis Society funds have allowed us to run the very first clinical study of bone micro-architecture in the knee after injury,” Dr. Boyd said. “It has the potential to change the field of osteoarthritis.” 

Bonus: Dr. Boyd and another Society-funded researcher are using this tool in rheumatoid arthritis patients to examine how biologics work.

Principal Applicant: Dr. Steven Boyd, University of Calgary, AB
Research Program: Strategic Operating Grant
Fund Term: 2015-2018
Fund Amount: $358,364