Understanding what happens immediately after an ACL knee injury

Soccer, football, skiing: Tearing your anterior cruciate ligament (ACL), a major ligament in the knee that controls motion, is one of the most common knee injuries. Each year, about 25,000 Canadians suffer an injury to their ACL and at least half of them will develop osteoarthritis within a decade.

“In 10 years after an ACL injury, 50 per cent of people will have osteoarthritis detectable by X-rays,” says Emily Bishop, a biomedical engineering researcher who recently defended her PhD. “That’s not including others who may not be at the stage yet where it’s detectable.”

Osteoarthritis, an extremely painful joint disease, develops when “the smooth covering of your bones, the cartilage, starts to wear down and leads to painful joint motion,” says Bishop.

Not just an older person's disease

The thousands of Canadians who get their ACLs surgically repaired every year still have an increased risk of developing osteoarthritis. “A lot of people think it’s an older person’s disease but there are a lot of young people, teenagers, early 20s at risk,” says Bishop. “If you’ve injured your ACL at 16, by 26 you likely already have some degeneration happening in the knee.”

Bishop — who chose University of Calgary’s well established Biomedical Engineering (BME) Graduate Program after studying mechanical engineering at Queen’s — has spent the last five years working to understand what happens to knee motion immediately after an ACL injury. The BME program has more than 60 principal investigators from five faculties — engineering, medicine, kinesiology, veterinary medicine and science — who work with industry to solve complex challenges and translate these solutions into products and services that help individuals and society.

Harmful changes seen as early as six weeks after ACL injury

"Using novel measures, I was able to show potentially harmful changes in knee stability to both the injured and non-injured legs as early as six weeks after injury,” she says. “If we can better understand and detect these early changes, we can use that information to optimize rehabilitation protocols and monitor osteoarthritis development and progression.”

Information from Bishop’s research could also help develop new brace technologies to restore joint stability and evaluate new techniques for ACL surgeries. “Right now, the risk of developing osteoarthritis in the knee remains about the same whether you get surgery or not” she says. "BME provides a unique opportunity to work with clinicians and researchers to solve these complex problems.”

Bishop has been busy outside the lab too. She helped organize the annual Alberta Biomedical Engineering Conference where students get experience presenting their research, and she co-edited the Journal of Undergraduate Research in Alberta where students can get published.

She is wrapping up work in Janet Ronsky’s lab in the Schulich School of Engineering and figuring out next steps. “I am keen to explore opportunities in the biomedical industry in Calgary,” she says.

As she looks ahead to joining one of the fastest-growing sectors in global health innovation and product development, Bishop is also looking back on her graduate work at the University of Calgary.

“I've been fortunate to participate in collaborative research teams and have gained invaluable training,” she says. “I am very happy with my choice of BME at the University of Calgary.”

 

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