Targeting prolonged arthrogenic muscle responses following anterior cruciate ligament reconstruction to prevent knee joint pathomechanics

Prolonged knee joint pathomechanics (KJPM) are a major concern with respect to post-traumatic osteoarthritis following reconstructive surgery of the anterior cruciate ligament. The underlying causes of KJPM remain unclear. Neuromuscular responses to a feeling of instability and/or fear of movement have been observed, referred to as arthrogenic muscle responses (AMR). Recently strong indications of supraspinal physiopathological mechanisms have been uncovered, including from pilot work in our consortium. With the proposed fundamental research project we wish to capitalize on this. First, we will gain a detailed understanding of these mechanisms through the use of high density electro-encephalography (hdEEG) in combination with advanced motion capture, exposing associations between cortical activations, AMR and KJPM. Once that is established, opportunities to inhibit AMR through the application of dual-tasking will be identified, assuming that this will also suppress KJPM. Building on the new knowledge, the effectiveness of ideal circumstance interventions will be evaluated in terms of suppressing KJPM, either indirectly inhibiting AMR through dual-task training, or directly inhibiting AMR through externally focused real-time feedbackdelivery. Altogether, the uniquely comprehensive understanding will 
provide solid evidence for the development of the next generation knee injury rehabilitation strategies.