Research Department, Centre for Military Medicine, P.O. Box 50, FIN 00301 Helsinki, Finland.
J Bone Joint Surg Am. 2010 Sep;92 Suppl 1 Pt 2:258-64. doi: 10.2106/JBJS.J.00450.
Surgical treatment of Osgood-Schlatter disease is occasionally warranted, but its long-term prognosis remains poorly investigated. We studied the rate of occurrence of surgical treatment of unresolved Osgood-Schlatter disease as well as the clinical course, radiographic characteristics, and long-term outcomes after that treatment in a large population of military recruits.
During a thirteen-year period, 178 consecutive recruits underwent surgery for unresolved Osgood-Schlatter disease, and 107 of them (117 knees) who met the inclusion criteria participated in a follow-up examination. We obtained data from the original medical records and radiographs as well as follow-up information from physical and radiographic examinations, interviews, and questionnaires to determine functional outcomes.
The rate of occurrence of surgically treated unresolved Osgood-Schlatter disease was forty-two per 100,000 military recruits. The median age at the onset of symptoms was fifteen years. After a median duration of follow-up of ten years after the surgery, ninety-three patients (87%) reported no restrictions in everyday activities or at work and eighty (75%) had returned to their preoperative level of sports activity. The median modified Kujala score was 95 points, and the median visual analog score for pain was 7 mm. Forty-one patients (38%) reported a complete absence of pain when kneeling. Six patients had experienced minor postoperative complications, and two had undergone a reoperation for the treatment of the Osgood-Schlatter disease. After resection, the mean tibial tuberosity thickness decreased by 47%. The mean Insall-Salvati index was 1.0 preoperatively and 1.09 postoperatively (p = 0.003), and the corresponding mean Blackburne-Peel indexes were 0.85 and 0.95 (p = 0.003). With the numbers studied, the symptom duration, surgical methods, and radiographic indexes were not found to have an effect on the outcome of surgery.
In the great majority of young adults, the functional outcome of surgical treatment of unresolved Osgood-Schlatter disease is excellent or good, the residual pain intensity is low, and postoperative complications or subsequent reoperations are rare.
Osgood-Schlatter 病的手术治疗偶尔是必要的，但它的长期预后仍未得到充分研究。我们研究了未解决的 Osgood-Schlatter 病手术治疗的发生率，以及在大量新兵中，该治疗后的临床过程、影像学特征和长期结果。
在十三年期间，178 名连续新兵因未解决的 Osgood-Schlatter 病接受手术治疗，其中符合纳入标准的 107 名（117 膝）参加了随访检查。我们从原始病历和 X 线片中获取数据，并通过体格检查和 X 线检查、访谈和问卷调查获得随访信息，以确定功能结果。
手术治疗未解决的 Osgood-Schlatter 病的发生率为每 10 万名新兵 42 例。症状出现的中位年龄为 15 岁。手术后中位随访十年后，93 名患者（87%）报告日常活动或工作不受限制，80 名（75%）恢复术前运动水平。改良 Kujala 评分中位数为 95 分，疼痛视觉模拟评分中位数为 7 毫米。41 名患者（38%）报告在跪着时完全没有疼痛。6 名患者术后出现轻微并发症，2 名患者因 Osgood-Schlatter 病再次手术。切除后，胫骨结节厚度平均减少 47%。术前 Insall-Salvati 指数为 1.0，术后为 1.09（p=0.003），相应的 Blackburne-Peel 指数分别为 0.85 和 0.95（p=0.003）。在研究的数量中，症状持续时间、手术方法和影像学指标与手术结果无关。
在大多数年轻成年人中，未解决的 Osgood-Schlatter 病手术治疗的功能结果是优秀或良好的，残留的疼痛强度较低，术后并发症或后续再次手术很少见。
