Abstract
Aim:If surgical intervention is necessary for Os-Good-Schlatter patients ,a number of surgical techniques including open surgical,arthroscopic and bursoscopic procedures are available.The aim of this study was to evaluate the mid-term clinical results of patients who underwent arthroscopic excision with the diagnosis of OSD.
Materials and Methods:This study was modeled with a retrospective design.16 patients who underwent arthroscopic ossicle excision were included in this study.The Visual Analog Scale (VAS) Score,Tegner Activity Scale and Lysholm Knee Score forms were administered to the patients in order to compare their pre-operative and post-operative condition.In addition,complications such as infection,residual bone fragments,re-hospitalization or recurrence were evaluated and recorded.
Results:A total of 16 patients were included in the study, and of these patients, 11 (68.75%) were male and 5 (31.25%) were female. The mean age of the patients is 28.8 (20–41 ± 7) years. The mean follow-up period was 82.9 (61–108 ± 15) months. The mean time for return to sports-related training activities for all of the patients was 9.2 (8–11) weeks. The mean VAS decreased from 6.8 ± 1.1 points preoperatively, to 5.7 ± 1.3 at the final follow-up (P < 0.001). In addition, the mean Tegner Activity Level score improved from 5.7 ± 0.6 preoperatively to 7.8 ± 0.9 at the final follow-up (P < 0.001). The mean Lysholm Knee Scale score was 77.4 ± 4.6 points in the preoperative period, increasing to 97.7 ± 5.8 points at the final follow-up (P < 0.001). In one patient, recurrence occurred at the 105th postoperative month and revision surgery was performed.
Conclusion:Arthroscopic ossicle excision for OSD can be considered an adequate technique when the mid-term results are evaluated.Although rare, recurrence may occur after arthroscopic surgery.In order to demonstrate the superiority of the arthroscopic method over open surgical procedures, comparative studies containing long-term results are required.
References
- Lucenti L, Sapienza M, Caldaci A, De Cristo C, Testa G, Pavone V, et al. The Etiology and Risk Factors of Osgood-Schlatter Disease: A Systematic Review 2022. https://doi.org/10.3390/children9060826.
- Cohen B, Wilkinson RW. The Osgood-Schlatter lesion; a radiological and histological study. Am J Surg 1958;95:731–42. https://doi.org/10.1016/0002-9610(58)90622-6.
- Lucenti L, Sapienza M, Caldaci A, De Cristo C, Testa G, Pavone V, et al. The Etiology and Risk Factors of Osgood-Schlatter Disease: A Systematic Review 2022. https://doi.org/10.3390/children9060826.
- Cohen B, Wilkinson RW. The Osgood-Schlatter lesion; a radiological and histological study. Am J Surg 1958;95:731–42. https://doi.org/10.1016/0002-9610(58)90622-6.
- Nkaoui M, el Alouani EM. Osgood-schlatter disease: risk of a disease deemed banal. Pan Afr Med J 2017;28. https://doi.org/10.11604/PAMJ.2017.28.56.13185.
- Indiran V, Jagannathan D. Osgood-Schlatter Disease. N Engl J Med 2018;378:e15. https://doi.org/10.1056/NEJMICM1711831.
- Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter syndrome. Curr Opin Pediatr 2007;19:44–50. https://doi.org/10.1097/MOP.0B013E328013DBEA.
- Ladenhauf HN, Seitlinger G, Green DW. Osgood-Schlatter disease: a 2020 update of a common knee condition in children. Curr Opin Pediatr 2020;32:107–12. https://doi.org/10.1097/MOP.0000000000000842.
- Vaishya R, Azizi AT, Agarwal AK, Vijay V. Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review. Cureus 2016;8. https://doi.org/10.7759/CUREUS.780.
- Glynn MK, Regan BF. Surgical treatment of Osgood-Schlatter’s disease. J Pediatr Orthop 1983;3:216–9. https://doi.org/10.1097/01241398-198305000-00012.
- Weiss JM, Jordan SS, Andersen JS, Lee BM, Kocher M. Surgical treatment of unresolved Osgood-Schlatter disease: ossicle resection with tibial tubercleplasty. J Pediatr Orthop 2007;27:844–7. https://doi.org/10.1097/BPO.0B013E318155849B.
- Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood–Schlatter disease: review of the literature. Musculoskelet Surg 2017;101:195–200. https://doi.org/10.1007/S12306-017-0479-7.
- Eun SS, Lee SA, Kumar R, Sul EJ, Lee SH, Ahn JH, et al. Direct bursoscopic ossicle resection in young and active patients with unresolved Osgood-Schlatter disease. Arthroscopy 2015;31:416–21. https://doi.org/10.1016/J.ARTHRO.2014.08.031.
- Yaray O, Akesen B, Ocaklioǧlu G, Aydinli U. Validation of the Turkish version of the visual analog scale spine score in patients with spinal fractures. Acta Orthop Traumatol Turc 2011;45:353–8. https://doi.org/10.3944/AOTT.2011.2528.
- Briggs KK, Kocher MS, Rodkey WG, Steadman JR. Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 2006;88:698–705. https://doi.org/10.2106/JBJS.E.00339.
- Celik D, Coşkunsu D, Kılıçoğlu Ö. Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res 2013;471:2602–10. https://doi.org/10.1007/S11999-013-3046-Z.
- DeBerardino TM, Branstetter JG, Owens BD. Arthroscopic treatment of unresolved Osgood-Schlatter lesions. Arthroscopy 2007;23:1127.e1-1127.e3. https://doi.org/10.1016/J.ARTHRO.2006.12.004.
- Flowers MJ, Bhadreshwar DR. Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. J Pediatr Orthop 1995;15:292–7. https://doi.org/10.1097/01241398-199505000-00005.
- Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. Undefined 1990;10:65–8. https://doi.org/10.1097/01241398-199001000-00012.
- El-Husseini TF, Abdelgawad AA. Results of surgical treatment of unresolved Osgood-Schlatter disease in adults. J Knee Surg 2010;23:103–7. https://doi.org/10.1055/S-0030-1267474.
- Results of surgical treatment of unresolved Osgood-Schlatter lesion | Read by QxMD n.d. https://read.qxmd.com/read/11204962/results-of-surgical-treatment-of-unresolved-osgood-schlatter-lesion (accessed November 1, 2022).
- Circi E, Beyzadeoglu T. Results of arthroscopic treatment in unresolved Osgood-Schlatter disease in athletes. Int Orthop 2017;41:351–6. https://doi.org/10.1007/S00264-016-3374-1.
- Lee YS, Ahn JH, Chun D il, Yoo JH. A case of arthroscopic removal of symptomatic ossicle associated with Osgood-Schlatter disease in an athletic. European Journal of Orthopaedic Surgery and Traumatology 2011;21:301–4. https://doi.org/10.1007/S00590-010-0697-2.
- Beyzadeoglu T, Inan M, Bekler H, Altintas F. Arthroscopic excision of an ununited ossicle due to Osgood-Schlatter disease. Arthroscopy 2008;24:1081–3. https://doi.org/10.1016/J.ARTHRO.2007.03.010.
- 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:e813–8. https://doi.org/10.1016/J.EATS.2021.12.041.
- Tsakotos G, Flevas DA, Sasalos GG, Benakis L, Tokis A v. Osgood-Schlatter Lesion Removed Arthroscopically in an Adult Patient. Cureus 2020;12. https://doi.org/10.7759/CUREUS.7362.
- Zhi-Yao LI. Arthroscopic Excision of a Huge Ununited Ossicle Due to Osgood-Schlatter Disease in an Adult Patient. J Orthop Case Rep 2013;3:4–7. https://doi.org/10.13107/JOCR.2250-0685.092.
Abstract
Amaç: Osgood-Schlatter hastalarında cerrahi müdahale gerekiyorsa açık cerrahi, artroskopik ve bursoskopik işlemler de dahil olmak üzere çok sayıda cerrahi teknik mevcuttur. Bu çalışmanın amacı Osgood-Schlatter tanısıyla artroskopik eksizyon uygulanan hastaların orta dönem klinik sonuçlarını değerlendirmektir.
Gereç ve Yöntem: Bu çalışma retrospektif olarak modellenmiştir. Artroskopik kemikçik eksizyonu yapılan 16 hasta çalışmaya dahil edilmiştir. Hastaların ameliyat öncesi ve ameliyat sonrası durumlarını karşılaştırmak amacıyla Görsel Analog Skala (VAS) Skoru, Tegner Aktivite Skalası ve Lysholm Diz Skoru formları uygulanmıştır. Ayrıca enfeksiyon, kalıntı kemik parçaları, yeniden hastaneye yatış veya nüks gibi komplikasyonlar da değerlendirilerek kaydedildi.
Bulgular: Çalışmaya toplam 16 hasta dahil edildi ve bu hastaların 11'i (%68,75) erkek, 5'i (%31,25) kadındı. Hastaların ortalama yaşı 28,8 (20-41±7) yıldı. Ortalama takip süresi 82,9 (61-108 ± 15) aydı. Tüm hastaların sporla ilgili antrenman faaliyetlerine dönüş süresi ortalama 9,2 (8-11) haftaydı. Ortalama VAS ameliyat öncesi 6,8 ± 1,1 puandan son takipte 5,7 ± 1,3'e düştü (p<0,001). Ek olarak, ortalama Tegner Aktivite Düzeyi skoru ameliyat öncesi 5,7 ± 0,6'dan son takipte 7,8 ± 0,9'a yükseldi (p<0,001). Ortalama Lysholm Diz Skalası skoru ameliyat öncesi dönemde 77,4 ± 4,6 puan iken, son takipte 97,7 ± 5,8 puana yükseldi (p<0,001). Bir hastada postoperatif 105. ayda nüks gelişti ve revizyon ameliyatı uygulandı.
Sonuç: Osgood-Schlatter hastalığı için artroskopik kemikçik eksizyonu, orta dönem sonuçları değerlendirildiğinde yeterli bir teknik olarak düşünülebilir. Artroskopik cerrahi sonrası nadir de olsa nüks meydana gelebilir. Artroskopik yöntemin açık cerrahi işlemlere üstünlüğünü ortaya koymak amacıyla uzun dönemli karşılaştırmalı çalışmalar yapılabilir.
Ethical Statement
Çalışma için kurumumuzdan etik kurul onayımız mevcuttur
Supporting Institution
Destekleyen kurum bulunmamaktadır
References
- Lucenti L, Sapienza M, Caldaci A, De Cristo C, Testa G, Pavone V, et al. The Etiology and Risk Factors of Osgood-Schlatter Disease: A Systematic Review 2022. https://doi.org/10.3390/children9060826.
- Cohen B, Wilkinson RW. The Osgood-Schlatter lesion; a radiological and histological study. Am J Surg 1958;95:731–42. https://doi.org/10.1016/0002-9610(58)90622-6.
- Lucenti L, Sapienza M, Caldaci A, De Cristo C, Testa G, Pavone V, et al. The Etiology and Risk Factors of Osgood-Schlatter Disease: A Systematic Review 2022. https://doi.org/10.3390/children9060826.
- Cohen B, Wilkinson RW. The Osgood-Schlatter lesion; a radiological and histological study. Am J Surg 1958;95:731–42. https://doi.org/10.1016/0002-9610(58)90622-6.
- Nkaoui M, el Alouani EM. Osgood-schlatter disease: risk of a disease deemed banal. Pan Afr Med J 2017;28. https://doi.org/10.11604/PAMJ.2017.28.56.13185.
- Indiran V, Jagannathan D. Osgood-Schlatter Disease. N Engl J Med 2018;378:e15. https://doi.org/10.1056/NEJMICM1711831.
- Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter syndrome. Curr Opin Pediatr 2007;19:44–50. https://doi.org/10.1097/MOP.0B013E328013DBEA.
- Ladenhauf HN, Seitlinger G, Green DW. Osgood-Schlatter disease: a 2020 update of a common knee condition in children. Curr Opin Pediatr 2020;32:107–12. https://doi.org/10.1097/MOP.0000000000000842.
- Vaishya R, Azizi AT, Agarwal AK, Vijay V. Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review. Cureus 2016;8. https://doi.org/10.7759/CUREUS.780.
- Glynn MK, Regan BF. Surgical treatment of Osgood-Schlatter’s disease. J Pediatr Orthop 1983;3:216–9. https://doi.org/10.1097/01241398-198305000-00012.
- Weiss JM, Jordan SS, Andersen JS, Lee BM, Kocher M. Surgical treatment of unresolved Osgood-Schlatter disease: ossicle resection with tibial tubercleplasty. J Pediatr Orthop 2007;27:844–7. https://doi.org/10.1097/BPO.0B013E318155849B.
- Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood–Schlatter disease: review of the literature. Musculoskelet Surg 2017;101:195–200. https://doi.org/10.1007/S12306-017-0479-7.
- Eun SS, Lee SA, Kumar R, Sul EJ, Lee SH, Ahn JH, et al. Direct bursoscopic ossicle resection in young and active patients with unresolved Osgood-Schlatter disease. Arthroscopy 2015;31:416–21. https://doi.org/10.1016/J.ARTHRO.2014.08.031.
- Yaray O, Akesen B, Ocaklioǧlu G, Aydinli U. Validation of the Turkish version of the visual analog scale spine score in patients with spinal fractures. Acta Orthop Traumatol Turc 2011;45:353–8. https://doi.org/10.3944/AOTT.2011.2528.
- Briggs KK, Kocher MS, Rodkey WG, Steadman JR. Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 2006;88:698–705. https://doi.org/10.2106/JBJS.E.00339.
- Celik D, Coşkunsu D, Kılıçoğlu Ö. Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res 2013;471:2602–10. https://doi.org/10.1007/S11999-013-3046-Z.
- DeBerardino TM, Branstetter JG, Owens BD. Arthroscopic treatment of unresolved Osgood-Schlatter lesions. Arthroscopy 2007;23:1127.e1-1127.e3. https://doi.org/10.1016/J.ARTHRO.2006.12.004.
- Flowers MJ, Bhadreshwar DR. Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. J Pediatr Orthop 1995;15:292–7. https://doi.org/10.1097/01241398-199505000-00005.
- Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. Undefined 1990;10:65–8. https://doi.org/10.1097/01241398-199001000-00012.
- El-Husseini TF, Abdelgawad AA. Results of surgical treatment of unresolved Osgood-Schlatter disease in adults. J Knee Surg 2010;23:103–7. https://doi.org/10.1055/S-0030-1267474.
- Results of surgical treatment of unresolved Osgood-Schlatter lesion | Read by QxMD n.d. https://read.qxmd.com/read/11204962/results-of-surgical-treatment-of-unresolved-osgood-schlatter-lesion (accessed November 1, 2022).
- Circi E, Beyzadeoglu T. Results of arthroscopic treatment in unresolved Osgood-Schlatter disease in athletes. Int Orthop 2017;41:351–6. https://doi.org/10.1007/S00264-016-3374-1.
- Lee YS, Ahn JH, Chun D il, Yoo JH. A case of arthroscopic removal of symptomatic ossicle associated with Osgood-Schlatter disease in an athletic. European Journal of Orthopaedic Surgery and Traumatology 2011;21:301–4. https://doi.org/10.1007/S00590-010-0697-2.
- Beyzadeoglu T, Inan M, Bekler H, Altintas F. Arthroscopic excision of an ununited ossicle due to Osgood-Schlatter disease. Arthroscopy 2008;24:1081–3. https://doi.org/10.1016/J.ARTHRO.2007.03.010.
- 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:e813–8. https://doi.org/10.1016/J.EATS.2021.12.041.
- Tsakotos G, Flevas DA, Sasalos GG, Benakis L, Tokis A v. Osgood-Schlatter Lesion Removed Arthroscopically in an Adult Patient. Cureus 2020;12. https://doi.org/10.7759/CUREUS.7362.
- Zhi-Yao LI. Arthroscopic Excision of a Huge Ununited Ossicle Due to Osgood-Schlatter Disease in an Adult Patient. J Orthop Case Rep 2013;3:4–7. https://doi.org/10.13107/JOCR.2250-0685.092.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 9, 2024 |
| Submission Date | June 5, 2024 |
| Acceptance Date | July 19, 2024 |
| Published in Issue | Year 2024 |