Published: April 19, 2019 By

Corey Neu and Rachel Frank

Donnelly Family Endowed Associate Professor Corey Neu (left) from the College of Engineering and Applied Science at CU Boulder and Dr. Rachel Frank (right) from CU Orthopedics at CU Anschutz Medical Campus

Donnelly Family Endowed Associate Professor Corey Neu of the Department of Mechanical Engineering at CU Boulder is working with colleagues at CU Anschutz Medical Campus to detect early osteoarthritis, allowing younger patients to seek treatment earlier and possibly ward off the most severe measures.

Neu and his team of orthopedic surgeons and radiologists, which includes Dr. Rachel Frank at CU Orthopedics, will study the knees of 50 young adults who have injured their anterior cruciate ligaments or ACLs, an injury common among active Coloradans that increases a person’s chance of developing osteoarthritis.

Osteoarthritis affects over 20 million people in the United States and is the most common degenerative joint disease, according to the American Academy of Orthopaedic Surgeons. Frequently associated with older populations, osteoarthritis causes pain, swelling and stiffness in the hands, hips and knees. In severe cases, patients may lose the ability to complete daily tasks. When this happens, a knee or hip replacement is necessary.

With $2.7 million in funding from the National Institutes of Health, Neu and Frank will determine if functional imaging methods, which focus on assessment of cartilage health and elasticity in the knee, can predict osteoarthritis in humans. If successful, patients can begin treatments such as physical therapy, changes in activity, weight loss, injection treatments, medication or minimally invasive arthroscopy long before joint replacement is their only option. 

“When you’re older with end-stage arthritis, it is more reasonable to consider joint replacement. Unfortunately, when a younger patient develops end-stage arthritis, joint replacement surgery is less ideal,” Frank said. “A younger person may require multiple future revision surgeries over his or her lifetime and/or may need to decrease levels of sports and fitness participation. The key is trying to diagnose, and thus treat, arthritis early before irreversible changes occur.”

Knee replacement joint and diagram on whiteboard

Nue demonstrates how an artificial knee joint fits in the knee. His team aims to diagnose osteoarthritis early on, so joint replacements can be avoided.

For this reason, Neu and his team are studying patients younger than 45 who will be undergoing ACL reconstruction. Those with ACL injuries are likely to develop cartilage degeneration, enabling researchers to track early progression of the disease more reliably.

“The fact that our research explores a sports-related injury really helps to bolster biomedical efforts and research across Colorado,” Neu said.

X-rays and MRIs can diagnose advanced tissue disease, but they haven’t been able to detect early osteoarthritis, Neu said. Currently, X-rays and MRIs measure only significant changes in joint shape, so when degeneration is just beginning and not yet severe, it is hard to identify. As a result, instead of joint shape, Neu and his team will measure strain and material properties within cartilage.

“Your cartilage tissues change with every step you take,” Neu said. “They help transmit force from your foot up through your leg and provide a low-friction surface so your knee can move and flex easily. By measuring these biomechanical changes in cartilage, we may be able to predict which patients will develop osteoarthritis.”  

To do so, an MRI will be taken with the patient’s leg connected to a device that applies force on the knee to mimic walking. As the leg moves, changes in cartilage are mapped over time. Steady levels of strain or material properties indicate a healthy joint, while large, abnormal measurements indicate early stages of osteoarthritis.

“Cartilage is more than just a slippery surface; it’s an impressive and complex material only a few millimeters thick that allows you to take thousands of steps each day over decades of your life,” Neu said.

Neu will be leveraging MRI resources in northern Colorado like the Intermountain Neuroimaging Consortium, a state-of-the-art MRI scanner in Boulder devoted to research. He is also thrilled to be collaborating with CU Orthopedics and physicians at Anschutz Medical Campus.

“We have a unique opportunity to bridge resources across institutions with outstanding partners at CU Anschutz Medical Campus,” Neu said. “We can’t do this kind of science in isolation. Not only is it more efficient, but it’s more fun to work with people who have dedicated expertise.”