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Fujita K, Nakase J, Yoshimizu R, Kimura M, Kanayama T, Tsuchiya H. Bursoscopic Ultrasound-Guided Ossicle Resection for Osgood-Schlatter Disease. Arthrosc Tech 2022; 11:e841-e846. [PMID: 35646559 PMCID: PMC9134316 DOI: 10.1016/j.eats.2021.12.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Osgood-Schlatter disease commonly affects physically active adolescents. It is a common cause of anterior knee pain and inflammation in this population. Its symptoms typically subside with conservative therapy. Surgery, including resection of mobile ossicles, is considered when the pain persists on kneeling or during sports after the skeletal maturity. In this procedure, we use a direct bursoscopic approach with ultrasound-guided ossicle resection. In comparison with the classical arthroscopic approach, the bursoscopic approach uses more distally placed portals. These reduce the risk of damage to the fat pad, meniscus, and ligament. Endoscopic surgeries, including arthroscopic and bursoscopic surgeries, use intraoperative fluoroscopy to resect ossicles because the ossicle cannot be clearly identified by endoscopic imaging alone. Fluoroscopy exposes patients and surgeons to radiation. Ultrasound-guided surgery identifies the exact positional relationship between the ossicle and grasping forceps without radiation exposure since fluoroscopy is unnecessary. Moreover, the risk of residual ossicles is reduced because tiny ossicles, which are difficult to detect under fluoroscopy, are visible on ultrasound. Ultrasound-guided ossicle resection was a viable treatment option for Osgood-Schlatter disease because it eliminated radiation exposure and reduced the risk of missed ossicles.
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Affiliation(s)
- Kentaro Fujita
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
| | - Rikuto Yoshimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
| | - Mitsuhiro Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
| | - Tomoyuki Kanayama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Japan
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McDonough GR, Rossi MJ. Arthroscopic Resection of Symptomatic Tibial Tubercle Ossicles for Recalcitrant Osgood-Schlatter Disease Using a 2-Portal Technique. Arthrosc Tech 2022; 11:e813-e818. [PMID: 35646564 PMCID: PMC9134260 DOI: 10.1016/j.eats.2021.12.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/22/2021] [Indexed: 02/03/2023] Open
Abstract
Arthroscopic resection of symptomatic unfused tibial tubercle ossicles causing chronic anterior knee pain due to recalcitrant Osgood-Schlatter disease has been shown to be a reproducible arthroscopic technique. Although a number of other surgical techniques have been described, including ossicle excision and tubercle-plasty, drilling of the tibial tubercle, bone peg insertion to induce fusion, open excision of loose fragments, direct bursoscopic ossicle resection, and closing-wedge tubercle osteotomy, with varied outcomes, this technique offers a minimally invasive approach with low risk. Complications including injury to the patellar tendon and scarring of the anterior fat pad have been previously reported, but this approach can be performed with minimal fat pad debridement and direct visualization of the patellar tendon during all resections. This article presents a technique for arthroscopic resection and debridement of unfused ossicles in patients with chronic anterior knee pain due to Osgood-Schlatter disease by use of minimally invasive arthroscopic techniques that are used in standard knee arthroscopy and should be familiar to most arthroscopists.
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Affiliation(s)
| | - Michael J. Rossi
- Address correspondence to Michael J. Rossi, M.D., M.S., Department of Orthopedic Surgery, Confluence Health, 820 N Chelan Ave, Wenatchee, WA 98801, U.S.A.
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Kamiya T, Teramoto A, Mori Y, Kitamura C, Watanabe K, Yamashita T. Nano-Arthroscopic Ultrasound-Guided Excision of Unresolved Osgood-Schlatter Disease. Arthrosc Tech 2021; 10:e1581-e1587. [PMID: 34258207 PMCID: PMC8252821 DOI: 10.1016/j.eats.2021.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/15/2021] [Indexed: 02/03/2023] Open
Abstract
The nano-arthroscopic ultrasound-guided ossicle excision technique is used in the management of an unresolved Osgood-Schlatter disease. The NanoScope is inserted slightly lateral to the proximal patella tendon and moved on between the ossicle and anterior surface of the proximal tibia under ultrasonographic guidance. The 5-mm skin incision is made as a working portal on the medial side of the proximal patella tendon. The proximal border of the ossicle is clearly identified after bursectomy. Then, the ossicles are removed piece by piece using a 2-mm arthroscopic punch. During the resection, the remaining ossicle is continuously confirmed by ultrasound. Finally, the complete excision of the ossicle is shown by the nano-arthroscopic view and ultrasound. The patient is allowed to have a full weight-bearing and an unrestricted range of motion on the day of surgery. Patients are permitted to resume their sports activities without any restriction after 6 weeks. This technique is recommended to athletes who suffer from painful unresolved Osgood-Schlatter disease because of the benefits of it being a minimally invasive surgery with an early postoperative recovery.
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Affiliation(s)
- Tomoaki Kamiya
- Address correspondence to Tomoaki Kamiya, M.D., Ph.D., Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Cuo-ku, Sapporo, 060-8543, Japan.
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Surgical Treatment Outcomes of Unresolved Osgood-Schlatter Disease in Adolescent Athletes. Case Rep Orthop 2021; 2021:6677333. [PMID: 33815856 PMCID: PMC7990524 DOI: 10.1155/2021/6677333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 11/18/2022] Open
Abstract
The purpose of this case series is to report the outcomes of ossicle excision and tubercleplasty for unresolved Osgood-Schlatter disease that has failed conservative treatment in six adolescent athletes. A retrospective chart review was completed, and data collected include age at onset of symptoms, age at surgery, sex, laterality, mechanism of injury, conservative treatment regimen, radiographic findings, sports played, time to return to sport, length of follow-up, and Lysholm score. Surgery involved an open ossicle excision, tubercleplasty, and repair of the patellar tendon to bone using a suture anchor. Postoperatively, patients were allowed to fully weight-bear in an extension knee brace for 4 weeks and then allowed to gradually resume activity. Four males and 2 females were studied. The right knee was involved in 3 cases and the left knee in 3. The average age at onset of symptoms was 15.8 (range 12-18) and at surgery was 17.3 (range 17-18). Radiographic findings included a large bump in 4 cases, an ossicle in 2, and free fragments at the tendon insertion in 3. Sports played included basketball, football, running, and dancing. All patients returned to sports at an average of 21 weeks and 6 days postsurgery (range 8-56). The average length of follow-up was 14.2 weeks (range 5-27). The average Lysholm score postsurgery was 97.2 (range 94-100). Surgical treatment of unresolved Osgood-Schlatter disease was successful in all patients. No patients reported any postoperative complications or additional surgery. For skeletally mature and symptomatic patients, we recommend removal of the ossicle and adjacent bursae, smoothing the bump, and repairing the patellar tendon to bone.
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Tsakotos G, Flevas DA, Sasalos GG, Benakis L, Tokis AV. Osgood-Schlatter Lesion Removed Arthroscopically in an Adult Patient. Cureus 2020; 12:e7362. [PMID: 32328374 PMCID: PMC7174857 DOI: 10.7759/cureus.7362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 11/05/2022] Open
Abstract
Osgood-Schlatter disease is a traction apophysitis of the tibial insertion of the patellar tendon. It consists one of the most common causes of knee pain in adolescents and usually presents in young males and it is considered a self-limiting condition. Although the symptoms disappear after the closure of the growth plate in most cases, in some patients they may persist. A variety of conservative treatments are used in most cases, however surgical intervention can be successful for patients who have intolerable symptoms. Most surgical options of the Osgood-Schlatter disease include open procedures, while arthroscopic or direct bursoscopic excision has been reported. We believe that the arthroscopic removal of an unresolved Osgood-Schlatter might be the most appropriate treatment for this condition, and we present a case of a male patient with an ununited ossicle due to an Osgood-Schlatter lesion, which was removed arthroscopically using a multidirectional arthroscope and a motorized semi-hooded barrel burr.
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Affiliation(s)
- George Tsakotos
- Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | | | | | - Leonardos Benakis
- Arthroscopy and Orthopaedic Surgery, Metropolitan Hospital, Athens, GRC
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Abstract
PURPOSE OF REVIEW Osgood-Schlatter disease (OSD) is one of the most common causes for anterior knee pain in children and adolescents resulting from a traction apophysitis of the tibial tubercle. While a peak in boys aged 12-15 years old was well documented, there seems to be no difference in sex distribution nowadays. This may result from increased participation of young females in high-impact sports. This review provides an up-to-date account on contemporary prophylaxis as well as diagnostic and therapeutic approaches. RECENT FINDINGS Numerous studies have examined risk factors for OSD. These include body weight, muscle tightness, muscle weakness during knee extension and flexibility of hamstring muscles. In particular, shortening of the rectus femoris may substantially alter biomechanical functions of the knee. Conservative management remains successful in over 90% of patients. However, if disabling symptoms and pain persistent after physeal closure, operative treatment may be necessary. SUMMARY OSD is a mostly self-limiting apophysitis of the tibial tubercle and the adjacent patella tendon in young active patients with open physis. Prevention strategies include quadriceps and hamstring stretching and therefore should be implemented in everyday practice routines for children who partake in regular sports activities.
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Omodaka T, Ohsawa T, Tajika T, Shiozawa H, Hashimoto S, Ohmae H, Shitara H, Ichinose T, Sasaki T, Hamano N, Takagishi K, Chikuda H. Relationship Between Lower Limb Tightness and Practice Time Among Adolescent Baseball Players With Symptomatic Osgood-Schlatter Disease. Orthop J Sports Med 2019; 7:2325967119847978. [PMID: 31192270 PMCID: PMC6540499 DOI: 10.1177/2325967119847978] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Osgood-Schlatter disease (OSD) is characterized by traction apophysitis of the tibial tuberosity. Few studies on symptomatic and asymptomatic OSD have correlated findings with clinical examination. Purpose: To investigate the relationship between lower limb tightness and practice time among adolescent baseball players with symptomatic OSD. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study participants were 402 male baseball players (N = 804 knees) with a mean ± SD age of 10.9 ± 1.5 years (range, 7-14 years). Participant age, height, body weight, body mass index, practice time per week, range of motion of the hip and ankle joints, heel-buttock distance (HBD), and straight-legged raise angle were evaluated. Tibial tuberosity development, as assessed with ultrasonography, was classified into 4 stages: cartilaginous, apophyseal, epiphyseal, and bony. Knees that were classified as apophyseal or epiphyseal were investigated. Participants were divided into 3 groups: non-OSD, asymptomatic OSD, and symptomatic OSD. Results: Of 400 knees in the apophyseal and epiphyseal stages, 23 knees had asymptomatic OSD, and 11 had symptomatic OSD. Players with symptomatic OSD practiced for significantly longer than the non-OSD group (P = .001) and asymptomatic OSD group (P = .001). Players with symptomatic OSD also had a larger HBD (P = .006) and smaller range of motion regarding internal rotation of hip (P = .023) and dorsiflexion of the ankle (P = .013) than the non-OSD group. Conclusion: Players with symptomatic OSD had longer practice times than the non-OSD and asymptomatic OSD players. Symptomatic OSD was also associated with tightness of the lower limbs as assessed by the HBD and range of motion in the hip and ankle joints.
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Affiliation(s)
- Takuya Omodaka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Takashi Ohsawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hiroyuki Shiozawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Syogo Hashimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hiroaki Ohmae
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tsuyoshi Ichinose
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Noritaka Hamano
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
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Cairns G, Owen T, Kluzek S, Thurley N, Holden S, Rathleff MS, Dean BJF. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med 2018; 4:e000383. [PMID: 30167318 PMCID: PMC6109948 DOI: 10.1136/bmjsem-2018-000383] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2018] [Indexed: 12/19/2022] Open
Abstract
Objective Evaluate effectiveness and harms of interventions for patellar tendon related pain in children and adolescents. Design Systematic review and meta-analysis. Data sources Medline via Pubmed, Embase via OVID, CINAHL via Ebsco, SportDiscus up until 24 November 2017 were searched. Eligibility criteria for selecting studies Inclusion criteria were (1) controlled or randomised controlled clinical trials (RCTs), (2) participants with diagnosis of patellar tendon related disorder, (3) participants≤18 years of age at enrolment and (4) published in a peer-reviewed English or Scandinavian language journal. Results Of 530 studies identified, eight were included after screening, with three included in data synthesis. To be included in data synthesis, we required studies to have included (and have data available for) a minimum of 10 participants under 18 years. All studies were rated as being at high risk of bias. For adolescents with patellar tendinopathy, one RCT compared eccentric exercises to usual care and found no difference between groups. In adolescents with Osgood-Schlatter disease (OSD), injection of local anaesthetic with dextrose proved superior to either usual care or local anaesthetic alone (three armed RCTs). In a retrospective case controlled study in adolescents with OSD, surgery provided no benefit over conservative management in terms of persistent symptoms and had a higher complication rate. Conclusion There is weak evidence to support the use of dextrose injection with local anaesthetic and no evidence to support the use of specific types of exercises to treat children/adolescents with OSD/patellar tendinopathy. Until further evidence arises, clinicians should include load modification and advise on a return to sport based on symptoms.
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Affiliation(s)
- George Cairns
- Bristol Medical School, University of Bristol Medical School, Bristol, UK
| | - Timothy Owen
- Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Stefan Kluzek
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, UK.,Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Neal Thurley
- Bristol Medical School, University of Bristol Medical School, Bristol, UK.,Bodleian Health Care Libraries, Cairns Library, John Radcliffe Hospital, Oxford, UK
| | - Sinead Holden
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Benjamin John Floyd Dean
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, UK.,Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Abstract
Osgood–Schlatter disease (OSD) is known as a self-limiting condition but surgical excision of the ossicles may be required in adults resistant to conservative treatments. The ossicle associated to OSD is generally small and located outside the joint near the tibial tubercle; however, large or intra-articular ossicle has been reported rarely. Here, we report an unusual case of OSD with a separated, large-sized ossicle that protruded into the knee joint and treated by arthroscopy-assisted excision of the ossicle.
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Affiliation(s)
- Wonchul Choi
- Orthopaedics, CHA University/Cha Bundang Medical Center, Sungnam, KOR
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Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood-Schlatter disease: review of the literature. Musculoskelet Surg 2017; 101:195-200. [PMID: 28593576 DOI: 10.1007/s12306-017-0479-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Osgood-Schlatter disease (OSD) is a self-limiting condition which occurs commonly in adolescence. PURPOSE The objective of this article is to review published literature regarding pathophysiology, diagnosis and treatment of OSD. METHODS A search of the literature was performed on the electronic databases PubMed, Cochrane and SCOPUS databases between 1962 and 2016 for pathophysiology, diagnosis and treatment of Osgood-Schlatter disease. RESULTS OSD, also known as apophysitis of the tibial tubercle, is a common disease with most cases resolving spontaneously with skeletal maturity. In pathophysiology, the most accepted theory is repetitive knee extensor mechanism contraction. The pain is localized to the anterior aspect of the proximal tibia over the tibial tuberosity. They may describe a dull ache exacerbated by jumping or stair climbing. Radiological evaluation may indicate superficial ossicle in the patellar tendon. Osgood-Schlatter is a self-limited disease and generally ceases with skeletal maturity. Treatment is usually symptomatic. Adults with continued symptoms may need surgical treatment if they fail to respond to conservative treatment. Surgical procedures include open, bursoscopic and arthroscopic technique. Arthroscopic surgery is beneficial over an open procedure due to early postoperative recovery, no incisional scar in front of the tuberosity that usually causes discomfort in kneeling with a better cosmetic result and the ability to address concomitant intra-articular pathology. CONCLUSION Osgood-Schlatter syndrome runs a self-limiting course, and usually complete recovery is expected with closure of the tibial growth plate. Overall prognosis for Osgood-Schlatter syndrome is good, except for some discomfort in kneeling and activity restriction in a few cases. Arthroscopic techniques seem to be the best choice of treatment of unresolved Osgood-Schlatter lesions.
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Affiliation(s)
- E Circi
- Department of Orthopaedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Y Atalay
- Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - T Beyzadeoglu
- Department of Orthopaedics and Traumatology, Beyzadeoglu Clinic, Bagdat Cad. Cubukcu Apt. No:333/8, 34738, Erenkoy, Istanbul, Turkey.
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Halic University, Istanbul, Turkey.
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Pagenstert G, Wurm M, Gehmert S, Egloff C. Reduction Osteotomy of the Prominent Tibial Tubercle After Osgood-Schlatter Disease. Arthroscopy 2017; 33:1551-1557. [PMID: 28454996 DOI: 10.1016/j.arthro.2017.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 02/03/2017] [Accepted: 02/10/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the functional and clinical outcome of a new closing-wedge osteotomy for the prominent tibial tubercle after Osgood-Schlatter disease. METHODS Between 2010 and 2014, 7 consecutive adults (mean age, 28.6 years; range, 26-35 years) were treated by closing-wedge reduction osteotomy of a painful tibial tubercle. All patients had prior nonsurgical and surgical treatment. Preoperative and postoperative tubercular prominence, Caton-Deschamps index for patellar height, the Kujala Anterior Knee Pain Scale, Lysholm Knee Score as well as visual analog scale score and Tegner activity scores were recorded. RESULTS Mean follow-up after reduction osteotomy was 31.3 months (27-41 months). The bony prominence of the tibial tubercle was significantly reduced (mean 8 mm, P < .001) and the Caton-Deschamps index was lowered from 1.29 to 1.09 (P < .001). From preoperative to last follow-up, the Kujala Anterior Knee Pain Scale increased from 54.71 preoperative to 84.71 (P < .001); the Lysholm Knee Score improved from 72.42 to 94.14 (P < .001); the Tegner activity score increased from 3.1 to 5.7 (P < .001), whereas the visual analog scale significantly decreased from 5.8 to 1.2 (P < .001). No complications were recorded, and all patients were satisfied with clinical outcome. CONCLUSIONS Closing-wedge osteotomy of the tibial tubercle effectively reduced the bony prominence after Osgood-Schlatter disease and consecutively improved the outcome in terms of knee pain and function. Thus, we can recommend this procedure in selected patients. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Geert Pagenstert
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Markus Wurm
- Department of Orthopaedic Sports Medicine, Technische Universität München (TUM), Munich, Germany
| | - Sebastian Gehmert
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Christian Egloff
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland.
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Results of arthroscopic treatment in unresolved Osgood-Schlatter disease in athletes. INTERNATIONAL ORTHOPAEDICS 2016; 41:351-356. [DOI: 10.1007/s00264-016-3374-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/11/2016] [Indexed: 10/20/2022]
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Lee DW, Kim MJ, Kim WJ, Ha JK, Kim JG. Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease. Knee Surg Relat Res 2016; 28:62-7. [PMID: 26955614 PMCID: PMC4779807 DOI: 10.5792/ksrr.2016.28.1.62] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/13/2015] [Accepted: 09/18/2015] [Indexed: 11/04/2022] Open
Abstract
Purpose This study aims to evaluate magnetic resonance imaging (MRI) findings in young adults with symptomatic Osgood-Schlatter disease (OSD) and compare those in young adults without OSD. Materials and Methods We compared MRI findings between young adults with OSD (OS group, n=30) and the equivalent number of young adults without OSD (control group). Visual analog scale scores and Kujala scores were evaluated and correlation analysis was performed in the OS group. Results In the OS group, MRI revealed that the patellar tendon was attached to the tibia more widely, resulting in a reduced free tendon portion, and more proximally to the articular surface (p<0.001). The correlation analysis between MRI findings and clinical scores showed statistically significant correlations (p<0.01). In the OS group, 43% presented with patellar tendinopathy or bone marrow edema at the distal attachments. Conclusions Compared to the control group, the relatively small free portion and relatively proximal attachment of the patellar tendon were observed with MRI in the OS group. The free portion of the patellar tendon was positively correlated with the clinical scores. Patellar tendinopathy was also frequently encountered in the OS group.
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Affiliation(s)
- Dhong Won Lee
- Department of Orthopedic Surgery, Daejeon Military Hospital, Daejeon, Korea
| | - Min Jeong Kim
- Department of Raiology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Woo Jong Kim
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jeong Ku Ha
- Department of Orthopedic Surgery, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Jin Goo Kim
- Department of Orthopedic Surgery, Konkuk University Medical Center, Seoul, Korea
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Lui TH. Endoscopic Management of Osgood-Schlatter Disease. Arthrosc Tech 2016; 5:e121-5. [PMID: 27073771 PMCID: PMC4811213 DOI: 10.1016/j.eats.2015.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/27/2015] [Indexed: 02/03/2023] Open
Abstract
Osgood-Schlatter disease is a common cause of anterior knee pain in sports-practicing adolescents. The long-term outcomes have not always been favorable, and some adolescents have persisting knee pain into adulthood. Excision of the ossicle together with debridement of the tibial tuberosity is indicated if the pain is not relieved with conservative measures. An endoscopic technique for excision of the ossicle associated with Osgood-Schlatter disease is reported. It has the advantages of avoidance of painful surgical scars and preservation of the integrity of the patellar tendon, with the potential for improved cosmetic and functional results.
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Affiliation(s)
- Tun Hing Lui
- Address correspondence to Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.Department of Orthopaedics and TraumatologyNorth District Hospital9 Po Kin RoadSheung ShuiNTHong Kong SARChina
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