Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland.
Department of Orthopaedic Sports Medicine, Technische Universität München (TUM), Munich, Germany.
Arthroscopy. 2017 Aug;33(8):1551-1557. doi: 10.1016/j.arthro.2017.02.012. Epub 2017 Apr 25.
To evaluate the functional and clinical outcome of a new closing-wedge osteotomy for the prominent tibial tubercle after Osgood-Schlatter disease.
Between 2010 and 2014, 7 consecutive adults (mean age, 28.6 years; range, 26-35 years) were treated by closing-wedge reduction osteotomy of a painful tibial tubercle. All patients had prior nonsurgical and surgical treatment. Preoperative and postoperative tubercular prominence, Caton-Deschamps index for patellar height, the Kujala Anterior Knee Pain Scale, Lysholm Knee Score as well as visual analog scale score and Tegner activity scores were recorded.
Mean follow-up after reduction osteotomy was 31.3 months (27-41 months). The bony prominence of the tibial tubercle was significantly reduced (mean 8 mm, P < .001) and the Caton-Deschamps index was lowered from 1.29 to 1.09 (P < .001). From preoperative to last follow-up, the Kujala Anterior Knee Pain Scale increased from 54.71 preoperative to 84.71 (P < .001); the Lysholm Knee Score improved from 72.42 to 94.14 (P < .001); the Tegner activity score increased from 3.1 to 5.7 (P < .001), whereas the visual analog scale significantly decreased from 5.8 to 1.2 (P < .001). No complications were recorded, and all patients were satisfied with clinical outcome.
Closing-wedge osteotomy of the tibial tubercle effectively reduced the bony prominence after Osgood-Schlatter disease and consecutively improved the outcome in terms of knee pain and function. Thus, we can recommend this procedure in selected patients.
Level IV, therapeutic case series.
评估 Osgood-Schlatter 病后胫骨结节骨突出的新型闭合楔形截骨术的功能和临床结果。
2010 年至 2014 年，7 例连续成年患者（平均年龄 28.6 岁；范围 26-35 岁）接受了胫骨结节疼痛性闭合楔形截骨术。所有患者均接受过非手术和手术治疗。记录术前和术后胫骨结节隆起、Caton-Deschamps 髌骨高度指数、Kujala 膝关节前痛量表、Lysholm 膝关节评分以及视觉模拟评分和 Tegner 活动评分。
截骨术后平均随访 31.3 个月（27-41 个月）。胫骨结节的骨性隆起明显减少（平均 8mm，P<.001），Caton-Deschamps 指数从 1.29 降低到 1.09（P<.001）。从术前到最后一次随访，Kujala 膝关节前痛量表从术前的 54.71 分增加到 84.71 分（P<.001）；Lysholm 膝关节评分从 72.42 分提高到 94.14 分（P<.001）；Tegner 活动评分从 3.1 分增加到 5.7 分（P<.001），而视觉模拟评分从 5.8 分显著降低到 1.2 分（P<.001）。未记录到并发症，所有患者对临床结果均满意。
胫骨结节闭合楔形截骨术可有效减少 Osgood-Schlatter 病后的骨性隆起，并连续改善膝关节疼痛和功能的结果。因此，我们可以在选择的患者中推荐这种手术。
IV 级，治疗性病例系列。
