Treatment Of Osgood-Schlatter Disease Research Articles

A comprehensive MRI investigation to identify potential biomarkers of Osgood Schlatter disease in adolescents: A cross sectional study comparing Osgood Schlatter disease with controls.

Osgood-Schlatter disease (OSD) is the most common knee pain complaintamong adolescents playing sports. Despite this, there remains controversy over the pathophysiology and whether specific anatomical characteristics are associated with OSD. This study aimed to systematically and comprehensively characterize adolescents with OSD using magnetic resonance imaging (MRI) compared to pain-free controls, including both tissue abnormalities that may be associated with OSD, as well as anatomical characteristics. A secondary objective was to identify potential imaging biomarkers associated with pain. Cross-sectional study. Adolescents with OSD and controls were recruited from 2020 to 2022. Following a clinical exam, demographics, pain, sports participation, and Tanner stage were collected. Knee MRI was conducted on the participants' most symptomatic knee (OSD) or the dominant leg (controls). Sixty-seven adolescents (46 with OSD and 30 controls) were included. 80% of participants with OSD had at least one tissue alteration compared to 54% of controls. Compared to controls, OSD had 36.3 (95%CI 4.5 to 289.7) higher odds of bony oedema at the tibial tuberosity, and 32.7 (95%CI 4.1 to 260.6) and 5.3 (95%CI 0.6 to 46.2) higher odds of bony oedema at the tibial epiphysis and metaphysis respectively. Participants with OSD also had higher odds of fluid/oedema at the patellar tendon (12.3 95%CI 3.3 to 46.6), and superficial infrapatellar bursitis (7.2). Participants with OSD had a more proximal tendon attachment (mean tibial attachment portion difference, -0.05, 95% CI: -0.1 to 0.0, p = 0.02), tendon thickness (proximal mean difference, -0.09, 95% CI: -0.4 to 0.2, p = 0.04; distal mean difference, -0.6, 95% CI: -0.9 to -0.2, p = 0.01). Those with bony/tendon oedema had 1.8 points (95% CI: 0.3 to 3.2) higher pain on palpation than those without (t = -2.5, df = 26.6, p = 0.019), but there was no difference between these groups in a functional single leg pain provocation. Adolescents with OSD present with tissue and structural abnormalities on MRI that differed from age-matched controls. The majority had findings in the patellar tendon and bone, which often co-occurred. However, a small proportion of OSD also presents without alterations. It appears these findings may be associated with clinical OSD-related pain on palpation of the tibial tuberosity. Our highlight the pathophysiology on imaging, which has implications for understanding the mechanism and treatment of OSD.

Treatment of Osgood-Schlatter Disease in an Adolescent Athlete with Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: A Case Report

Introduction: Knee pain is one of the most frequent musculoskeletal symptoms in young physically active males. In some cases, it is very painful, can be hard to treat, and often lead to heterotopic ossification of the patellar tendon. To our knowledge, there are no reported cases of remission of ossification after clinical intervention. Case presentation: A 13-year-old Swedish boy with a 3-year anamnesis of severe Osgood-Schlatter with significant ossification of the patellar tendon at the point of tuberositas tibiae, was treated with injections of Liquid Platelet-Rich Fibrin (C-PRF) and Heat-Coagulated Albumin Gel (ALB-PRF) using a horizontal centrifuge system. He recovered and presented a near complete remission of ossification of the patellar tendon two months after treatment and could return to sport after a 3-year break. Conclusion: This case raises the hypothesis that Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel may be an effective intervention in the treatment of Osgood-Schlatter disease. Further research is required to test this theory.

The development of an informative leaflet for children and adolescents suffering from Osgood-Schlatter disease.

The mainstay in the treatment of Osgood-Schlatter Disease (OSD) is guidance on activity modification alongside exercises. The purpose of this study was to create an informative leaflet for patients with OSD, based on evidence and stakeholders perspectives. A synthesis of the literature, including national reference work, clinical research, and systematic reviews informed the initial leaflet. Twelve children with OSD and four clinical experts provided feedback through semi-structured interviews. After incorporating stakeholder input, the leaflet 'Osgood-Schlatter-Information and guidance' was developed. This provides a resource to assist the provision of information and translation of the current evidence.

Treatment of Osgood-Schlatter disease: review of the literature.

Osgood-Schlatter disease (OSD) is a self-limiting condition which occurs commonly in adolescence. The objective of this article is to review published literature regarding pathophysiology, diagnosis and treatment of OSD. 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. 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. 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.

Results of Arthroscopic Treatment in Unresolved Osgood-Schlatter Disease in Athletes

Purpose:Osgood-Schlatter disease (OSD) is common causes of knee pain in adolescent. Most patients respond to conservative treatment. However surgical treatment has been recommended for unresolved OSD. The aim of this study was to determine the outcomes of arthroscopic ossicle excision in athletes with unresolved OSD.Methods:Between September 2008 and November 2014, arthroscopy was performed 11 knees of 11 patients with OSD. The inclusion criteria were patients who underwent arthroscopic surgery with more than one year follow-up after surgery. Patients have a documented history of OSD with refractory pain over the tibial tubercle for a mean of 15.5 months (range, 7 to 24 months; SD, 7.5 months). The mean age was 23 years (range, 19 to 29 years; SD, 2.8 years). The mean follow-up period was 66.1 months (range, 15 to 96 months; SD, 25.6 months).Results:The mean return the sports activities after the surgery was 6.7 weeks (range 5 to 9 weeks; SD 1.3 weeks). The mean Kujala patellofemoral score improved from 82.9 (range 80 to 88 points; SD 2.6) preoperatively to 98.5 (range 96 to 100 points; SD 1.6) at final follow-up (p<0.01).In addition, the mean Lysholm knee scale was 87.5 (range 86 to 90 points; SD 1.7) in the preoperative period and increased to 96.9 (range 94 to 100 points; SD 2.5) at final follow-up(p<0.01). The mean Tegner activity level was 7.5 (range 6 to 8; SD 0.9) in the preoperative period and increased to 8.5 (range 7 to 9; SD 0.9) after surgery (p<0.01).Conclusions:We investigated the functional outcomes after arthroscopic treatment of unresolved OSD in athletes. In the all athletes, the arthroscopic treatment of OSD yielded satisfactory functional recovery. No postoperative complication were located. All patients were able to return the same level athletic activity. Level of evidence: Therapeutic Level IV. Key terms: Osgood-Schlatter disease, athletes, knee arthroscopy, ununited ossicle

Evaluation and conservative treatment for Osgood-Schlatter disease: A critical review of the literature

Background Osgood-Schlatter disease (OSD) is a tibial tubercle traction apophysitis resulting from repetitive strain on the patellar tendon insertion. OSD can lead to significant functional limitations and disability that can persist into adulthood. Methods The authors of this review systematically searched PubMed, CINAHL, TWUniversal, and The Cochrane Library for articles dated from January 1980 to December 2013 that related to the evaluation and conservative treatment of Osgood-Schlatter disease. Search phrases included ‘Osgood-Schlatter disease AND diagnosis’ and ‘Osgood-Schlatter disease AND treatment’. Articles were assessed for evidence strength based upon modified criteria from the evidence-based medicine pyramid and the diagnosis and treatment sections of the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Table. Findings There is a wealth of evidence to support a clinical diagnosis of Osgood-Schlatter disease. There is also fair evidence to employ functional outcome measures during evaluation. Evidence concerning conservative treatments for Osgood-Schlatter disease ranges from poor to strong based upon the intervention. Conclusion While strong evidence for clinical diagnosis is supported by the literature, further research is required to establish definitive functional outcome measures and effective interventions in the management of Osgood-Schlatter disease.

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

To examine the potential of dextrose injection versus lidocaine injection versus supervised usual care to reduce sport alteration and sport-related symptoms in adolescent athletes with Osgood-Schlatter disease. Girls aged 9 to 15 and boys aged 10 to 17 were randomly assigned to either therapist-supervised usual care or double-blind injection of 1% lidocaine solution with or without 12.5% dextrose. Injections were administered monthly for 3 months. All subjects were then offered dextrose injections monthly as needed. Unaltered sport (Nirschl Pain Phase Scale < 4) and asymptomatic sport (Nirschl Pain Phase Scale = 0) were the threshold goals. Sixty-five knees in 54 athletes were treated. Compared with usual care at 3 months, unaltered sport was more common in both dextrose-treated (21 of 21 vs 13 of 22; P = .001) and lidocaine-treated (20 of 22 vs 13 of 22; P = .034) knees, and asymptomatic sport was more frequent in dextrose-treated knees than either lidocaine-treated (14 of 21 vs 5 of 22; P = .006) or usual-care-treated (14 of 21 vs 3 of 22; P < .001) knees. At 1 year, asymptomatic sport was more common in dextrose-treated knees than knees treated with only lidocaine (32 of 38 vs 6 of 13; P = .024) or only usual care (32 of 38 vs 2 of 14; P < .0001). Our results suggest superior symptom-reduction efficacy of injection therapy over usual care in the treatment of Osgood-Schlatter disease in adolescents. A significant component of the effect seems to be associated with the dextrose component of a dextrose/lidocaine solution. Dextrose injection over the apophysis and patellar tendon origin was safe and well tolerated and resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than usual care.

Treatment of Osgood-Schlatter Disease by Prolotherapy: A Case Report

"Treatment of Osgood-Schlatter Disease by Prolotherapy: A Case Report." Journal of Orthopaedic Medicine, 15(3), pp. 62–63