Imagerie de la biomécanique et la caractérisation tissulaire quantitative : un nouveau paradigme pour mieux diagnostiquer les désordres musculosquelettiques

 

Nathalie Bureau

Centre de recherche du CHUM

 

Domaine : appareil locomoteur et arthrite

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2015-2016

Musculoskeletal disorders are common, debilitating conditions that impose an important socio-economical burden on health care services. Osteoarthritis of the knee also called degenerative joint disease, and tendon pathology, such as tennis elbow, are extremely common in the adult population.

Care management for these diseases is far from being optimal and this is in part due to the lack of specific markers to guide therapy. Studies show that knee malalignement is a risk factor for the onset and the progression of osteoarthritis but currently, traditional imaging modalities such as radiographs and MRI do not evaluate the knee dynamically and do not provide useful information regarding abnormal knee biomechanics. On the other hand, recent advances in the evaluation of the knee during gait using the KneeKG technology have shown promising results to help tailor treatment strategies such as physical therapy and orthotics to reduce pain and improve the quality of life in osteoarthritis patients.

Corticosteroid injections are commonly used for the treatment of tennis elbow although studies have shown that in most cases they only provide pain relief during the first 6 weeks, with a high recurrence rate after 8 weeks. A minimally invasive procedure called percutaneous tenotomy has shown encouraging results for the treatment of tennis elbow, in preliminary studies. Using ultrasound guidance, under local anesthesia a needle is advanced in the tendon and the tip of the needle is used to fenestrate the abnormal tissue to stimulate the physiological healing mechanisms. This technique could be a valid alternative to corticosteroid injections.

The first part of this research program aims at developing an imaging-based strategy for knee biomechanics evaluation and for tendon biomechanical properties quantification to improve diagnosis and treatment. The second part will evaluate the efficacy of percutaneous needle tenotomy for the treatment of tennis elbow.