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奥斯古德-施拉特病的治疗:文献综述

Treatment of Osgood-Schlatter disease: review of the literature.

作者信息

Circi E, Atalay Y, Beyzadeoglu T

机构信息

Department of Orthopaedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey.

Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

出版信息

Musculoskelet Surg. 2017 Dec;101(3):195-200. doi: 10.1007/s12306-017-0479-7. Epub 2017 Jun 7.

Abstract

BACKGROUND

Osgood-Schlatter disease (OSD) is a self-limiting condition which occurs commonly in adolescence.

PURPOSE

The objective of this article is to review published literature regarding pathophysiology, diagnosis and treatment of OSD.

METHODS

A search of the literature was performed on the electronic databases PubMed, Cochrane and SCOPUS databases between 1962 and 2016 for pathophysiology, diagnosis and treatment of Osgood-Schlatter disease.

RESULTS

OSD, also known as apophysitis of the tibial tubercle, is a common disease with most cases resolving spontaneously with skeletal maturity. In pathophysiology, the most accepted theory is repetitive knee extensor mechanism contraction. The pain is localized to the anterior aspect of the proximal tibia over the tibial tuberosity. They may describe a dull ache exacerbated by jumping or stair climbing. Radiological evaluation may indicate superficial ossicle in the patellar tendon. Osgood-Schlatter is a self-limited disease and generally ceases with skeletal maturity. Treatment is usually symptomatic. Adults with continued symptoms may need surgical treatment if they fail to respond to conservative treatment. Surgical procedures include open, bursoscopic and arthroscopic technique. Arthroscopic surgery is beneficial over an open procedure due to early postoperative recovery, no incisional scar in front of the tuberosity that usually causes discomfort in kneeling with a better cosmetic result and the ability to address concomitant intra-articular pathology.

CONCLUSION

Osgood-Schlatter syndrome runs a self-limiting course, and usually complete recovery is expected with closure of the tibial growth plate. Overall prognosis for Osgood-Schlatter syndrome is good, except for some discomfort in kneeling and activity restriction in a few cases. Arthroscopic techniques seem to be the best choice of treatment of unresolved Osgood-Schlatter lesions.

摘要

背景

奥斯古德-施拉特病(OSD)是一种常见于青少年的自限性疾病。

目的

本文旨在综述已发表的关于OSD病理生理学、诊断和治疗的文献。

方法

在1962年至2016年期间,对电子数据库PubMed、Cochrane和SCOPUS数据库进行文献检索,以查找有关奥斯古德-施拉特病病理生理学、诊断和治疗的内容。

结果

OSD,也称为胫骨结节骨突炎,是一种常见疾病,大多数病例在骨骼成熟后会自行缓解。在病理生理学方面,最被认可的理论是膝关节伸肌机制的反复收缩。疼痛局限于胫骨近端胫骨结节的前方。患者可能会描述为跳或爬楼梯时加剧的隐痛。放射学评估可能显示髌腱中有浅表小骨。奥斯古德-施拉特病是一种自限性疾病,通常在骨骼成熟时停止。治疗通常是对症治疗。持续有症状的成年人如果对保守治疗无反应,可能需要手术治疗。手术方法包括开放手术、关节镜下手术和关节镜手术。关节镜手术优于开放手术,因为术后恢复早,结节前方无切口瘢痕(通常会导致跪着时不适),美容效果更好,并且能够处理合并的关节内病变。

结论

奥斯古德-施拉特综合征病程自限,通常随着胫骨生长板闭合有望完全恢复。奥斯古德-施拉特综合征的总体预后良好,除了少数病例在跪着时有些不适和活动受限。关节镜技术似乎是治疗未解决的奥斯古德-施拉特病变的最佳选择。

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