Rhim Hye Chang, Bjork Lori B, Shin Jaehyung, Park Jewel, DeLuca Stephanie E, McCarron Katelyn C, Jang Ki-Mo, Ha Chris
Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation, Boston, MA 02115, USA.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905, USA.
Diagnostics (Basel). 2025 May 19;15(10):1282. doi: 10.3390/diagnostics15101282.
Although Osgood-Schlatter disease (OSD) is often self-limiting following apophyseal closure, it may cause persistent symptoms into adulthood, affecting physical and functional activities. The purpose of this systematic review is to summarize the current evidence on the efficacy of hyperosmolar dextrose injection for patients with OSD unresponsive to conservative treatment. Multiple databases were searched for studies investigating the efficacy of hyperosmolar dextrose injection in patients with OSD. Two reviewers independently extracted data and evaluated the risk of bias. Meta-analyses were performed to compare hyperosmolar dextrose injection with placebo injections. Four studies including three randomized controlled trials (RCTs) and one case series involving a total of 166 (162 males and 4 females) patients with 184 knees were included in this review. At three months, there was no significant difference in patient-reported improvement from baseline between hyperosmolar dextrose injection and placebo injections (standardized mean difference [SMD] = 1.92, 95% confidence interval [CI], -0.12 to 3.96; I = 96.2%). However, a meta-analysis of two RCTs including athletic pediatric patients found a pooled risk ratio of 2.11 (95% CI: 1.12 to 3.98, I = 30.73%) for pain-free return to sports at three months. In addition, at one year, a meta-analysis of two RCTs showed greater patient-reported improvement from baseline with hyperosmolar dextrose injection compared to placebo (SMD = 1.09, 95% CI, 0.62 to 1.56; I= 0%). Based on the limited number of RCTs, although no improvement in patient-reported outcomes is seen at three months, hyperosmolar dextrose injection may safely facilitate a pain-free return to sports at three months and lead to patient-reported improvement at one year. However, further high-quality RCTs are needed to substantiate these findings.
虽然奥斯古德-施拉特病（OSD）在骨骺闭合后通常会自行缓解，但它可能会导致成年后仍有持续症状，影响身体和功能活动。本系统评价的目的是总结高渗葡萄糖注射对保守治疗无效的OSD患者疗效的现有证据。检索了多个数据库，以查找研究高渗葡萄糖注射对OSD患者疗效的研究。两名评价者独立提取数据并评估偏倚风险。进行荟萃分析以比较高渗葡萄糖注射与安慰剂注射。本评价纳入了四项研究，包括三项随机对照试验（RCT）和一项病例系列，共涉及166例（162例男性和4例女性）患者的184个膝关节。三个月时，高渗葡萄糖注射与安慰剂注射相比，患者报告的自基线改善情况无显著差异（标准化均数差[SMD]=1.92，95%置信区间[CI]，-0.12至3.96；I²=96.2%）。然而，对两项包括运动儿科患者的RCT进行的荟萃分析发现，三个月时无痛恢复运动的合并风险比为2.11（95%CI：1.12至3.98，I²=30.73%）。此外，在一年时，对两项RCT的荟萃分析显示，与安慰剂相比，高渗葡萄糖注射使患者报告的自基线改善情况更明显（SMD=1.09，95%CI，0.62至1.56；I²=0%）。基于有限数量的RCT，虽然三个月时患者报告的结局未见改善，但高渗葡萄糖注射可能安全地促进三个月时无痛恢复运动，并在一年时使患者报告的情况得到改善。然而，需要进一步的高质量RCT来证实这些发现。
