Saglam Fevzi, Serttas Muhammed Fatih
Sakarya University Faculty of Medicine, Serdivan, Sakarya, Turkey.
J Child Orthop. 2024 Sep 8;18(5):477-485. doi: 10.1177/18632521241276323. eCollection 2024 Oct.
Osteochondromas are common bone tumors with hyaline cartilage-covered heads, arising from cortical and medullary bone. Solitary medial proximal tibial osteochondromas (MPTOs) can cause pes anserinus syndrome via compression. However, the literature lacks comprehensive studies on MPTO-related pes anserinus syndrome and its surgical outcomes.
The study reviewed 227 patients diagnosed with osteochondroma between January 2018 and January 2022, with 21 patients meeting inclusion criteria: under 19 years, MPTO, surgical excision, histological diagnosis, ≥1-year follow-up. Cases with irregular follow-ups and multiple hereditary exostoses were excluded. Different surgical techniques were employed based on lesion characteristics. Postoperative weight bearing was allowed, and follow-ups involved postoperative complications assessment, clinical data collection, imaging, and functional evaluations using the International Knee Documentation Committee (IKDC) and Hospital for Special Surgery Pediatric Functional Activity Brief Scale scoring systems.
The study involved 21 adolescents (15 ± 2 years). Lesion types were predominantly pedunculated (86%) and surgical interventions involved pes anserinus split (76%) or tenoplasty (24%). No significant correlations were observed between lesion dimensions and IKDC scores. Split intervention led to a significant improvement in IKDC scores ( < 0.01), while tenoplasty showed similar results ( < 0.05). Athlete status did not affect IKDC scores significantly, but both athletes and non-athletes demonstrated improvements ( < 0.05).
The negative impact of MPTOs causing pes anserinus tendinitis on the patient's quality of life and activity can be completely corrected with surgical treatment. Complete pes anserinus tendon cutting and subsequent repair are recommended if they facilitate surgery. The study underscores the importance of surgical management for MPTO-related pes anserinus syndrome and provides insights into the effectiveness of different surgical techniques.
骨软骨瘤是常见的骨肿瘤，其头部覆盖有透明软骨，起源于皮质骨和髓质骨。孤立性胫骨近端内侧骨软骨瘤（MPTO）可通过压迫导致鹅足综合征。然而，文献中缺乏关于MPTO相关鹅足综合征及其手术结果的全面研究。
本研究回顾了2018年1月至2022年1月期间诊断为骨软骨瘤的227例患者，其中21例符合纳入标准：年龄在19岁以下、MPTO、手术切除、组织学诊断、随访≥1年。排除随访不规律和多发遗传性骨软骨瘤的病例。根据病变特征采用不同的手术技术。术后允许负重，随访包括术后并发症评估、临床数据收集、影像学检查，以及使用国际膝关节文献委员会（IKDC）和特殊外科医院儿童功能活动简要量表评分系统进行功能评估。
本研究纳入21名青少年（15±2岁）。病变类型主要为带蒂型（86%），手术干预包括鹅足劈开（76%）或肌腱成形术（24%）。病变大小与IKDC评分之间未观察到显著相关性。劈开干预使IKDC评分显著改善（<0.01），而肌腱成形术也有类似结果（<0.05）。运动员状态对IKDC评分无显著影响，但运动员和非运动员均有改善（<0.05）。
MPTO导致鹅足肌腱炎对患者生活质量和活动的负面影响可通过手术治疗完全纠正。如果有助于手术，建议完全切断鹅足肌腱并随后进行修复。该研究强调了MPTO相关鹅足综合征手术治疗的重要性，并提供了不同手术技术有效性的见解。
