Ozeki Nobutake, Koga Hideyuki, Nakamura Tomomasa, Nakagawa Yusuke, Hoshino Takashi, Amemiya Masaki, Sekiya Ichiro
Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Arthrosc Tech. 2024 Jan 1;13(4):102897. doi: 10.1016/j.eats.2023.102897. eCollection 2024 Apr.
Osgood-Schlatter disease (OSD) reduces participation in sports activities for adolescents, and, in unresolved cases of the disease in which daily life or sports activity after skeletal maturity are affected, surgical intervention to remove the ossicle is performed to alleviate symptoms. We present a real-time virtual sonography (RVS)-guided ossicle removal in unresolved OSD. The knee joint angle is set at 20°, which is the same position used in magnetic resonance imaging. A 1.5-cm longitudinal skin incision is made at the medial side of the tuberosity. An ultrasound probe covered with a sterile sleeve is then placed longitudinally at the level of tuberosity. The forceps is inserted to peel the patellar tendon off the posterior side of the ossicle. Then the anterior side of the ossicle is peeled off in both the transverse and longitudinal views. When the ossicle is unstable enough, forceps are used to grasp the ossicle and carefully remove it. RVS can see magnetic resonance imaging information in the surrounding area beyond what can be detected by the ultrasound probe, and RVS enables easy determination of the anatomical position of the ossicle, and removal of the ossicle is achieved with low invasiveness.
奥斯古德-施拉特病（OSD）会降低青少年参与体育活动的程度，对于该病未得到解决且骨骼成熟后日常生活或体育活动受到影响的病例，需进行手术干预以切除骨赘来缓解症状。我们展示了在未解决的OSD中实时虚拟超声（RVS）引导下的骨赘切除术。膝关节角度设定为20°，这与磁共振成像中使用的位置相同。在结节内侧做一个1.5厘米长的纵向皮肤切口。然后将覆盖有无菌套管的超声探头纵向放置在结节水平。插入镊子将髌腱从骨赘后侧剥离。然后在横向和纵向视图中剥离骨赘的前侧。当骨赘足够松动时，用镊子抓住骨赘并小心地将其取出。RVS能够看到超声探头所能检测到的周围区域之外的磁共振成像信息，RVS能够轻松确定骨赘的解剖位置，并且以低侵入性实现骨赘的切除。
