Eun Sang Soo, Lee Seung Ah, Kumar Ramakant, Sul Eun Jin, Lee Sang Ho, Ahn Jin Hwan, Chang Moon Jong
Department of Orthopedic Surgery, Wooridul Spine Hospital, Seoul, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Arthroscopy. 2015 Mar;31(3):416-21. doi: 10.1016/j.arthro.2014.08.031. Epub 2014 Oct 24.
The aim of this study was to determine the outcomes of bursoscopic ossicle excision in young and active patients with unresolved Osgood-Schlatter disease.
This retrospective study included 18 male military recruits. A direct bursoscopic ossicle excision was performed using low anterolateral and low anteromedial portals. Outcomes were evaluated using the Lysholm knee score, pain score on a visual analog scale (VAS) (from 0 to 10), and Tegner activity scale score. In addition, patients were asked whether they could kneel or squat and whether they were able to return to their duty after surgery. Patient satisfaction was evaluated using the VAS and by asking whether patients thought that the prominence of the tibial tuberosity was reduced and whether they would recommend the same surgical treatment to others. Complications after surgery were also evaluated.
The mean Lysholm knee score was 71 preoperatively and improved to 99 after surgery. The mean VAS pain score was 6.5 in the preoperative period and decreased to 0.9 after surgery. In addition, the mean Tegner activity scale score improved from 2.7 preoperatively to 6.2 at final follow-up. However, 4 patients were not able to return to their duty, and 4 patients still had difficulties with kneeling after surgery. A superficial infection occurred in 1 patient, and a recurrent ossicle formation was found in 1 patient. Of 18 patients, 17 were satisfied with their surgical outcomes, and the mean VAS score for patient satisfaction was 8.8. Furthermore, all but 1 patient would recommend the same surgical treatment to others. However, 6 patients did not believe that the prominence of the tibial tuberosity was reduced.
Bursoscopic ossicle excision showed satisfactory outcomes in selective young and active patients with persistent symptoms. However, bursoscopic surgery showed limitation in reducing the prominence of the tibial tuberosity.
Level IV, therapeutic case series.
本研究旨在确定在患有未解决的奥斯古德-施拉特病的年轻活跃患者中进行关节镜下骨赘切除术的结果。
这项回顾性研究纳入了18名男性新兵。通过前外侧低位和前内侧低位入路进行直接关节镜下骨赘切除术。使用Lysholm膝关节评分、视觉模拟量表（VAS）疼痛评分（0至10分）和Tegner活动量表评分评估结果。此外，询问患者术后是否能够跪或蹲以及是否能够重返工作岗位。使用VAS评估患者满意度，并询问患者是否认为胫骨结节突出减小以及是否会向他人推荐相同的手术治疗。还评估了术后并发症。
术前Lysholm膝关节评分平均为71分，术后提高到99分。术前VAS疼痛评分平均为6.5分，术后降至0.9分。此外，Tegner活动量表评分平均从术前的2.7分提高到最后随访时的6.2分。然而，4名患者无法重返工作岗位，4名患者术后仍难以跪下。1例患者发生浅表感染，1例患者发现骨赘复发。18例患者中，17例对手术结果满意，患者满意度的VAS评分平均为8.8分。此外，除1例患者外，所有患者均会向他人推荐相同的手术治疗。然而，6例患者不认为胫骨结节突出减小。
关节镜下骨赘切除术在有持续症状的选择性年轻活跃患者中显示出令人满意的结果。然而，关节镜手术在减小胫骨结节突出方面存在局限性。
IV级，治疗性病例系列。
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