青少年男性髌腱末端止点的 Osgood-Schlatter 病和骨骼成熟度评估。
Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males.
机构信息
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
出版信息
Orthop J Sports Med. 2014 Jul 18;2(7):2325967114542084. doi: 10.1177/2325967114542084. eCollection 2014 Jul.
BACKGROUND
Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center.
PURPOSE
To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort.
STUDY DESIGN
Cross-sectional study; Level of evidence, 3.
METHODS
Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US.
RESULTS
The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects' heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E (P < .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A (P < .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages (P < .05).
CONCLUSION
The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.
背景
Osgood-Schlatter 病（OSD）是胫骨结节的牵拉性撕脱性病变。超声检查（US）能够检测到病理变化，如软骨肿胀和胫骨结节骨化中心的碎裂。
目的
比较胫骨结节发育的 US 分期以及该患者队列中 OSD 的体格特征和患病率。
研究设计
横断面研究；证据水平，3 级。
方法
受试者包括 238 名男性（n=476 个关节），平均年龄 11.4±1.6 岁（范围 7-14 岁）。US 上胫骨结节的发育分为 3 个阶段：软骨阶段（C 期）、骺突阶段（A 期）和骺板阶段（E 期）。然后，研究人员调查了受试者在胫骨结节施加压力时是否有疼痛。评估了年龄、身高、体重、体重指数（BMI）、跟臀距离（HBD，cm）和直腿抬高角度（SLRA）。为了确认 OSD 的诊断，参与者必须符合以下临床标准：直接按压胫骨骨骺时疼痛、骨碎片和 US 检测到的骨化中心不规则。
结果
195 个膝关节处于 C 期，105 个膝关节处于 A 期，176 个膝关节处于 E 期。随着胫骨结节发育的进展，受试者的身高、体重和 BMI 显著增加。E 期 HBD 增加（P<.01）。各组之间的 SLRA 无显著差异。32 个膝关节（6.8%）存在骨碎片和骨化中心不规则：C 期 0 个，A 期 21 个（4.3%），E 期 11 个（2.3%）。A 期观察到的骨碎片和不规则更为常见（P<.01）。另一方面，有 10 个膝关节存在 OSD（2.1%）：C 期 0 个，A 期 3 个（0.6%），E 期 7 个（1.5%）。E 期 OSD 的发生率明显高于其他阶段（P<.05）。
结论
本研究表明，HBD 从 A 期增加到 E 期。OSD 的患病率在 E 期最高。
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