Tibial tuberosity osteochondrosis

Brief introduction of tibial tuberosity osteochondrosis This disease, also known as tibial tuberosity or osteochondritis, aseptic necrosis, traction osteophytes, is a juvenile disease, the child's tibial tuberosity becomes large with pain, in 1903, Osgood first reported some humerus In the case of partial avulsion of the nodule, Schlatter later proposed that the disease is osteophyte in the tongue-like drooping part of the upper humerus, so this disease is also called Osgood-Schlatter disease. basic knowledge The proportion of illness: the incidence rate is about 0.004% - 0.006% Susceptible people: boys who are born in 11 to 15 years old Mode of infection: non-infectious Complications: osteoarthritis

Causes of tibial tuberosity osteochondrosis

(1) Causes of the disease

The tibial tuberosity is a tongue-shaped protrusion extending from the upper end of the humerus to the lower part of the humerus (Fig. 1). The iliac crest is a drafting iliac crest with a patellar ligament on it, which is subjected to frequent stretching tension and tibial tuberosity. At the age of 11 years, the ossification center of the humerus appears. At about 16 years old, the ossification center of the nodule merges with the ossification center of the upper humerus. At the age of 18, the tibial tuberosity merges with the upper end of the humerus. Before the age of 18 There is a layer of proliferating cartilage between the nodule and the main bone. Under the cartilage, the new bone is weak, and the strong quadriceps contraction can cause the disease.

(two) pathogenesis

The disease occurs in the young growth period before the epiphysis is closed. The blood circulation is from the patellar ligament, and the quadriceps muscle develops faster. The muscle contraction causes the tension of the tibial tuberosity of the patellar ligament to increase and swell, causing the tibial tuberosity. Osteochondritis, strenuous exercise or trauma can lead to cumulative strain of the tibial tuberosity and even avulsion fracture, which affects blood circulation, causing ischemic necrosis of the epiphysis, due to differentiation of fibroblasts and active proliferation of osteoblasts, patellar ligament The soft tissue in and around it can be ossified, and there are new bones appearing in the anterior superior part of the tibial tuberosity. The histological appearance of these new bones is exactly the same as that of ossifying myositis, due to the traction of the patellar tendon Osteoblast activity at the tibial tuberosity promotes bone hyperplasia, increases the tibial tuberosity, and protrudes forward. The proximal humerus epiphysis can be fused early, causing high tibia and knee flexion and other complications after skeletal maturity. disease.

Prevention of osteochondrosis of the tibial tuberosity

The tibial tuberosity osteochondrosis often occurs in recruits. Due to improper training, in order to prevent the occurrence of such diseases, reasonable training methods should be adopted, step by step, exercise intensity should be small to large; improve the quality of the troops, and should not be out The result is blind and hard-drying; the treatment should be thorough, and the review should be timely to avoid further damage to the humerus as a result of premature exercise.

Exercise scientifically, prepare well before training, don't run excessively, jump, squat, step by step, avoid damage.

Complications of tibial tuberosity osteochondrosis Complications osteoarthritis

The disease may have two late complications:

1 Due to the uplift of the tibial tuberosity, the quadriceps stop moves up, making the irregular surface of the tibia and the lower end of the femur contact osteoarthritis, and the bilateral lateral position X can be taken when the quadriceps contract. Take the line and observe whether the position of the humerus is consistent. If there is displacement, it should be corrected by surgery.

2 abnormal osteophytes of the tibial tuberosity, early fusion with the epiphysis of the humerus caused knee flexion.

3 high tibia.

Symptoms of tibial tuberosity osteochondrosis common symptoms acid at the tibial tuberosity... tibia pain knee pain

The disease occurs in boys aged 11 to 15 years old, with knee pain as the main performance. When walking, it is obvious. When doing running, jumping exercise makes the quadriceps contract, and going upstairs, stretching the knees or kneeling to press the bones. When the pain is intensified, the pain can be caused by lameness. The pain can last for several months or years. After the epiphysis is completely ossified, the pain can disappear. The examination can be found that the tibial tuberosity is bulging, hard, thickened at the attachment of the patellar tendon and Swelling, and obvious tenderness. When the quadriceps muscle resists resistance and stretches the knee, the pain or tenderness is obviously aggravated. After adulthood, an asymptomatic protuberance remains, and occasionally there is a painful small bone in the patellar ligament, or Form a high tibia.

1. The affected part of the tibia and fibula is gradually enlarged and painful. Going up and down the stairs and walking fast can make the pain worse. In severe cases, there may be limp. The knees are weak.

2. The affected limb has a tibiofibular nodule, and the local tenderness is obvious, but the skin is not red or hot. Stretching the knee under resistance, local pain is aggravated.

Examination of tibial tuberosity osteochondrosis

X-ray performance: The lateral position of the knee joint, especially with a slight internal rotation, is most helpful for diagnosis. Because the tibial tuberosity is slightly outside the middle of the humerus. In the early stage of the disease, local soft tissue swelling, sputum thickening and subgingival fat pad disappeared. One or several free new bone fragments can be seen in front of the tibial tuberosity. In the later stage, the new bone fragments were more obvious, and the adjacent tibial tuberosity had bone hyperplasia.

Diagnosis and diagnosis of tibial tuberculosis of tibial tuberosity

Diagnose based on

1. Most occur in boys aged 12-18, often unilateral or bilateral (about 30%).

2. The onset is slow, and the affected limb is swollen, painful and tender.

3. X-ray film can show that the tibial tuberosity has a tongue-like callus, irregular, often with uplift and broken, uneven bone density. Soft tissue is swollen.

According to age (before 18 years old), strong exercise history, anterior knee pain is the main symptom, relieved after rest, increased pain after exercise or compression, sometimes claudication, local bulging, hard, tenderness (+) resistance knee extension When the pain is obviously aggravated, it can be diagnosed. X-ray films are also helpful for diagnosis.

The diagnosis of this disease is not difficult, but it needs to be differentiated from the normal tibial tuberosity variation. The blood supply of the tibial tuberosity is from the patellar ligament artery. After the ischemic necrosis, it can cause the ligament of the patellar tendon and soft tissue and the increase of the tibial tuberosity. Large, protuberance caused by inflammation of the accessory sac, is the cause of soft tissue swelling of the tibial tuberosity. The normal tibial tuberosity is highly variable, and there may be multiple ossification centers with different shapes. It should be differentiated and softened with the tibia. Identification of the joint fluid phase.

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