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Chandra R, Malik S, Ganti L, Minkes RK. Diagnosis and Management of Osgood Schlatter Disease. Orthop Rev (Pavia) 2024; 16:121395. [PMID: 39040500 PMCID: PMC11262732 DOI: 10.52965/001c.121395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
Osgood Schlatter disease is the inflammation of the tibial tubercle, right below the patella. It is prevalent in athletic adolescents experiencing growth plate maturation due to puberty. This case study highlights the main causes and symptoms of Osgood Schlatter disease (OSD) and relates them to a case about a 10-year-old girl who runs daily and is going through puberty. The authors also discuss recent research regarding OSD, which suggests that OSD will typically conclude after the child stops growing. Surgery is only needed in extreme cases where the growth or inflammation at the tibia continues to push onto the shinbone, even after puberty.
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Guszczyn T, Kulesza M, Maciąg G, Kicman A, Ławicki S. The Effectiveness of Treating Osgood-Schlatter Disease (OSD) with Leukocyte-Rich Platelet-Rich Plasma (LR-PRP) Depending on the Duration of the Disease. J Clin Med 2024; 13:4220. [PMID: 39064260 PMCID: PMC11278405 DOI: 10.3390/jcm13144220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Osgood-Schlatter disease (OSD) occurs mainly in physically active adolescents, causing significant physical activity restrictions. The aim of this study is to compare the effectiveness of treating OSD with leukocyte-rich platelet-rich plasma (LR-PRP) depending on the duration of the disease and to attempt to develop an alternative treatment method to the currently used conservative therapy. Methods: Treatment efficacy was evaluated using the VAS, Tegner, Lysholm, and KOOS scales. Subject satisfaction, return to sports activity, potential adverse effects, and X-ray evaluation were likewise used to assess the success of the procedure. Results: Analysis across all scales showed statistically significant treatment effectiveness with LR-PRP in both groups of patients. When comparing the two groups, significantly better treatment outcomes were achieved in the acute phase of OSD. Treatment satisfaction in the acute OSD group was 95%, compared to 64% in the chronic group. The MCID value after LR-PRP injection in acute OSD compared to chronic OSD reached 100% vs. 81% on the VAS scale, 95.5% vs. 55% on the Tegner scale, 95% vs. 47% on the Lysholm scale and 91% vs. 27% on the KOOS scale. No adverse effects were recorded in either group. Conclusions: The high efficacy of LR-PRP treatment in patients with acute OSD, in correlation with high safety, as well as rapid and lasting results, can be an effective and beneficial alternative to conservative treatment. This single procedure seems particularly justified in a group of young professional athletes, where absence from training can lead to serious consequences.
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Affiliation(s)
- Tomasz Guszczyn
- Department of Pediatric Orthopaedics and Traumatology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Monika Kulesza
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.K.)
| | - Grzegorz Maciąg
- Department of Pediatric Orthopaedics and Traumatology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Aleksandra Kicman
- Department of Aesthetic Medicine, Medical University of Bialystok, 15-267 Bialystok, Poland;
| | - Sławomir Ławicki
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland; (M.K.)
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Simoni P, Boitsios G, Saliba T, Cesaro E, Aparisi Gómez MP. Conventional Radiography Assessment of the Pediatric Knee: Pearls and Pitfalls. Semin Musculoskelet Radiol 2024; 28:327-336. [PMID: 38768597 DOI: 10.1055/s-0044-1782206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Knee pain is one of the most common indications for radiography in the evaluation of musculoskeletal disorders in children and adolescents. According to international guidelines, knee radiographs should be obtained when there is the suspicion of an effusion, limited motion, pain to palpation, inability to bear weight, mechanical symptoms (such as "locking"), and persistent knee pain after therapy. When indicated, radiographs can provide crucial information for the clinical decision-making process. Because of the developmental changes occurring in the knee during growth, the assessment of knee radiographs can be challenging in children and adolescents. Radiologists unfamiliar with the appearance of the knee on radiographs during skeletal maturation risk overcalling or overlooking bone lesions. Image acquisition techniques and parameters should be adapted to children. This article describes the most common challenges in distinguishing pathology from the normal appearance of knee radiographs in the pediatric population, offering some pearls and pitfalls that can be useful in clinical practice.
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Affiliation(s)
- Paolo Simoni
- Department of Radiology, Université Libre de Bruxelles, "Reine Fabiola" Children's University Hospital, Brussels, Belgium
| | - Grammatina Boitsios
- Department of Radiology, Université Libre de Bruxelles, "Reine Fabiola" Children's University Hospital, Brussels, Belgium
| | - Thomas Saliba
- Department of Radiology, Université Libre de Bruxelles, "Reine Fabiola" Children's University Hospital, Brussels, Belgium
| | - Edoardo Cesaro
- Department of Radiology, Université Libre de Bruxelles, "Reine Fabiola" Children's University Hospital, Brussels, Belgium
| | - Maria Pilar Aparisi Gómez
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, University of Auckland
- Department of Radiology, IMSKE, Valencia, Spain
- Department of Radiology, Te Toka Tumai Auckland (Auckland District Health Board), Auckland, New Zealand
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Hernandez-Lucas P, Leirós-Rodríguez R, García-Liñeira J, Diez-Buil H. Conservative Treatment of Sever's Disease: A Systematic Review. J Clin Med 2024; 13:1391. [PMID: 38592198 PMCID: PMC10932217 DOI: 10.3390/jcm13051391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Sever's disease, or calcaneal apophysitis, stands as the most prevalent cause of heel pain in children, often linked to sports like soccer, Australian football, and basketball. While various therapies are documented in the scientific literature, the standard choice is conservative treatment. Thus, the objective of this research was to assess the effectiveness of diverse conservative methods and techniques in alleviating Sever's disease symptoms. Methods: Systematic searches were conducted in October 2023 in PubMed, Web of Science, Scopus, SportDiscus, and PEDro, using terms like Osteochondritis, Osteochondrosis, Apophysitis, Sever's disease, Calcaneus, Adolescent, Child, and Childhood. The PEDro scale gauged methodological quality, and the Cochrane Risk of Bias tool evaluated the risk of bias. Results: Eight randomized controlled studies were included, featuring commonly used treatments such as insoles, therapeutic exercises, Kinesio taping, and foot orthoses. The methodological quality was generally good, with an average PEDro score of 6.75 points. Regarding bias, four articles had low risk, three had high risk, and one had some concern. Conclusions: Conservative treatment emerges as an effective option for alleviating symptoms associated with Sever's disease.
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Affiliation(s)
- Pablo Hernandez-Lucas
- Functional Biology and Health Sciences Department, University of Vigo, 36001 Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, 24401 Ponferrada, Spain
| | | | - Helena Diez-Buil
- Faculty of Physiotherapy, Gimbernat University Schools, 08172 Sant Cugat del Valles, Spain
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Wada N, Abe Y, Nakazawa R, Sakamoto M, Tajika T. Relationship between coordination variability and Osgood-Schlatter disease in male junior youth soccer players -cross-sectional study using an inertial measurement unit. Clin Biomech (Bristol, Avon) 2024; 112:106182. [PMID: 38237217 DOI: 10.1016/j.clinbiomech.2024.106182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/21/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Osgood-Schlatter disease is a common overuse injury, and motor coordination is discussed as a risk factor; however, no reports have examined motor coordination in young soccer players with Osgood-Schlatter disease. This study aimed to investigate the difference in motor coordination between Osgood-Schlatter disease-affected and non-affected soccer players on a junior youth soccer team. METHODS This cross-sectional study investigated 35 young soccer players of 12-15 years of age, who completed a self-administered questionnaire covering general information, injury history, and athletic experience. An inertial measurement unit was attached to the participant's thoracic spine, lumbar spine, pelvis, thigh, and lower leg. The sagittal plane tilt angle of each body segment during squatting was analyzed. The continuous relative phase was calculated using the sagittal plane tilt angle. The mean absolute relative phase and continuous relative phase variabilities were calculated and compared between Osgood-Schlatter disease-affected and non-affected players. FINDINGS The sagittal plane tilt angle of each body segment during static standing and maximum flexion did not differ between the two groups. However, the Osgood-Schlatter disease group had significantly less continuous relative phase variability between the lumbar spine and pelvis (P < 0.01, Cohen's d = 0.91). The Osgood-Schlatter disease group had significantly fewer participants with other sports experience (P = 0.032, φ = 0.36). INTERPRETATION Dysfunctional lower trunk and hip muscles may be leading to Osgood-Schlatter disease. It is suggested that a variety of physical activities should be performed in the junior age group to allow players to acquire a variety of movement patterns.
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Affiliation(s)
- Naoya Wada
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan; Department of Rehabilitation, Jobu Hospital for Respiratory Diseases, Japan.
| | - Yota Abe
- Department of Rehabilitation, Asakura Sports Rehabilitation Clinic, Japan
| | - Rie Nakazawa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan
| | - Masaaki Sakamoto
- Department of Physiotherapy, Takasaki University of Health and Welfare, Japan
| | - Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan
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Waghe VR, Ramteke SU. Role of Physiotherapy in Osgood-Schlatter's Disease in Adolescent Volleyball Smasher: A Case Report. Cureus 2024; 16:e53534. [PMID: 38445126 PMCID: PMC10912898 DOI: 10.7759/cureus.53534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/03/2024] [Indexed: 03/07/2024] Open
Abstract
A 14-year-old female presented to the sports physiotherapy with a diagnosis of Osgood-Schlatter's disease (OSD), a condition particularly prevalent in adolescents engaged in sports with repetitive knee motions, such as volleyball. This ailment commonly manifests at the tibia, directly beneath the patella, eliciting discomfort and inflammation. The chronic overuse injuries involve repetitive activities inducing fatigue in specific anatomical structures. Adequate recovery mechanisms allow for tissue adaptation, mitigating the risk of injury. In the absence of proper recovery, microtrauma ensues, instigating inflammation mediated by substances like histamines. The release of inflammatory cells and enzymes inflicts damage on local tissue, and prolonged stress contributes to degenerative changes, resulting in weakness, diminished flexibility, and chronic pain. These manifestations are intimately associated with OSD in chronic or recurrent instances. The primary symptom of OSD is knee pain, often of sufficient severity to induce limping. Patients report discomfort during activities such as kneeling, descending stairs, prolonged stationary positions, prolonged episodes of sitting with the knee rendered immobile, and engagement in sporting activities. This case study specifically underscores the efficacy of tailored physiotherapy in the management of OSD among adolescent volleyball players. The study's findings indicate that the patient successfully alleviated symptoms, facilitating recovery with improved outcomes. Furthermore, the physiotherapy regimen appears instrumental in enhancing the patient's functional mobility, as evidenced by the study's outcomes.
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Affiliation(s)
- Vaishnavi R Waghe
- Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapnil U Ramteke
- Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Guszczyn T, Kulesza M, Kicman A, Motyka J, Ławicki S. Enhanced Pain Relief and Function Improvement in Children with Osgood-Schlatter Disease: Leukocyte-Rich Platelet-Rich Plasma (LR-PRP) as a Complementary Treatment to Standard Conservative Therapy. Med Sci Monit 2023; 29:e941523. [PMID: 38105547 PMCID: PMC10740339 DOI: 10.12659/msm.941523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Osgood-Schlatter disease (OSD) causes pain and loss of function of the knee in growing children. This study aimed to evaluate pain and function of the knee joint in 152 growing children with chronic OSD before and after treatment with LR-PRP when used with standard conservative treatment. MATERIAL AND METHODS Treatment efficacy was evaluated using the VAS, Tegner, Lyshom, and KOOS scales. Patient satisfaction, post-surgery athletic performance, and X-ray assessment were also used to determine the success of the procedure. RESULTS We found that 75% of the subjects were satisfied with the results of the treatment, and 72% of the subjects returned to full physical activity. The analysis showed a significant decrease in the median VAS score after treatment compared to the pre-treatment score (P<0.05), and an increase in the median scores of the Tegner, Lysholm, and KOOS scales compared to the pre-treatment score (P<0.05; P<0.05; P<0.05, respectively). The results showed that the shorter the duration of the disease, the better the treatment results were received. Return to activity and patient satisfaction were highest in the study group previously rehabilitated. CONCLUSIONS LR-PRP injection of the tibial tuberosity in patients with chronic OSD with open growth cartilage is an effective and uncomplicated method. We did not observe any adverse effects, which suggests the relatively high safety of the procedure. The use of PRP in the earlier phase of the disease and additional rehabilitation before treatment significantly increases the effectiveness of treatment.
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Affiliation(s)
- Tomasz Guszczyn
- Department of Pediatric Orthopaedics and Traumatology, Medical University of Białystok, Białystok, Poland
| | - Monika Kulesza
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystokn Poland
| | - Aleksandra Kicman
- Departmeent of Aesthetic Medicine, Medical University of Białystok, Białystok, Poland
| | - Joanna Motyka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystokn Poland
| | - Sławomir Ławicki
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystokn Poland
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Bruzda R, Wilczyński B, Zorena K. Knee function and quality of life in adolescent soccer players with Osgood Shlatter disease history: a preliminary study. Sci Rep 2023; 13:19200. [PMID: 37932373 PMCID: PMC10628204 DOI: 10.1038/s41598-023-46537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023] Open
Abstract
The aim of the study was to assess psycho-physical deficits among young athletes with history of Osgood Shlatter Disease (OSD-H) compared to adolescents without history of knee pain (Control group). Eighteen participants were recruited from a group of 80 young (U14-U17) male soccer players. Medical records, and Knee Osteoarthritis Outcome Score (KOOS) were performed from both groups. The tests were conducted to assess the anthropometric characteristics, knee and ankle range of motion (Ely's and Weight Bearing Lunge tests), and muscle power of the lower limbs (Leg Press, Single Leg Countermovement Jump, and Single Leg Hop for Distance). Results showed that overall patient-relevant outcomes following OSD (87%) were significantly lower than in the Control group (95%) (p < 0.05). Scores of the KOOS subscales revealed that Quality of Life and Function, Sports and recreational activities were significantly lower in the OSD-H group (p < 0.05). Although, there were no differences in subscale scores for Pain, Symptoms and Daily Activities. There were, also no difference between groups in range of motion angles and muscle power of the lower limbs values. The preliminary results support existing knowledge indicate that OSD may have a long-term influence on function, sports and recreational participation, and quality of life on young athletes.
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Affiliation(s)
- Rafał Bruzda
- Gdansk College of Health, 80-335, Gdansk, Poland
| | - Bartosz Wilczyński
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, 80-219, Gdansk, Poland.
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, 80-219, Gdansk, Poland
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Takei S, Torii S, Taketomi S, Iizuka S, Tojima M, Iwanuma S, Iida Y, Tanaka S. Developmental stage and lower quadriceps flexibilities and decreased gastrocnemius flexibilities are predictive risk factors for developing Osgood-Schlatter disease in adolescent male soccer players. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07378-z. [PMID: 37002485 DOI: 10.1007/s00167-023-07378-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This study aimed to elucidate the influential predictive risk factors of Osgood-Schlatter disease (OSD) on the support (non-kicking) leg among adolescent soccer players considering peak height velocity (PHV) age and investigate the cut-off values of the predictive variables. METHODS A cohort of 302 Japanese adolescent male soccer players aged 12-13 years were followed over 6 months. All players underwent physical examination, tibial tubercle ultrasonography, anthropometric and whole-body composition measurements, and muscle flexibility test of the support leg at the baseline. The developmental stage was evaluated from the PHV age. The OSD of the support leg was diagnosed 6 months later; players were divided into the OSD and control (CON) groups. The predictive risk factors were analyzed by multivariate logistic regression analysis. RESULTS There were 42 players who had developed OSD at baseline and they were excluded from the study. Among the 209 players, 43 and 166 belonged to the OSD and CON groups, respectively. The predictive risk factors of OSD development were PHV age ± 6 months at baseline (p = 0.046), apophyseal stage of tibial tuberosity maturity at baseline (p < 0.001), quadriceps flexibility ≥ 35° at baseline (p = 0.017), and decrease in gastrocnemius flexibility in 6 months (p = 0.009). CONCLUSION PHV age ± 6 months at baseline, apophyseal stage of the tibial tuberosity at baseline, quadriceps flexibility ≥ 35° at baseline, and decrease in gastrocnemius flexibility in 6 months are predictive risk factors of OSD development in the support leg among adolescent male soccer players. It is crucial to know the PHV age of each player, and not only the flexibility of quadriceps muscle but also the gastrocnemius should be monitored to predict OSD. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Seira Takei
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Waseda Institute of Human Growth and Development, Saitama, Japan
| | - Suguru Torii
- Waseda Institute of Human Growth and Development, Saitama, Japan.
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Michio Tojima
- School of Health Sciences, Tokyo International University, Saitama, Japan
| | - Soichiro Iwanuma
- Department of School Education, Teikyo University of Science, Tokyo, Japan
| | - Yukako Iida
- Waseda Institute of Human Growth and Development, Saitama, Japan
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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