Lesions of the Tibial Tubercle Occurring During Adolescence

Osgood, Robert B.

doi:10.1097/01241398-199307000-00063

Cited by 16 publications

(26 citation statements)

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“…We can only speculate on the mechanism behind this association between OSD and increased PTS. Osgood 16 appropriately described the ossification of the upper tibial epiphysis as tongue-like, extending downward over the anterior surface of the diaphysis. In Ogden’s 14 extensive reports on tibial tuberosity development, he describes the physis underlying the tuberosity to be initially composed of almost all fibrocartilage rather than a columnar, hypertrophic cellular structure.…”

Section: Discussionmentioning

confidence: 99%

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association

et al. 2020

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Background: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tubercle caused by repetitive strain and chronic avulsion from the patellar tendon. No widely accepted anatomic risk factors have been associated with OSD. Purpose: To determine if OSD is associated with increased posterior tibial slope (PTS). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Forty knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients 10 to 15 years of age with a clinical diagnosis of OSD and available lateral radiograph and magnetic resonance imaging (MRI) were eligible. Age- and sex-matched patients with a history of knee pain but no evidence of OSD on clinical examination and without significant pathology on lateral radiograph and MRI were included in the control group. PTS was defined as the angle between a reference line perpendicular to the proximal anatomic axis and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral radiographs by 2 blinded investigators. Interrater reliability of PTS measurements was evaluated using intraclass correlation coefficient (ICC). The independent samples t test was used to compare PTS between the OSD and control knees. Results: The mean age was 12.6 ± 1.6 years and 51% (37/72) of the knees were from male youth. There were no differences in age, sex, and laterality of knees between the OSD and control groups. The mean PTS was significantly higher in the OSD group (12.23°± 3.58°) compared with the control group (8.82°± 2.76°; P < .001). The ICC was 0.931 (95% CI, 0.890-0.957), indicating almost perfect interrater reliability. Conclusion: This study identifies an association between OSD and increased PTS. The clinical implications of this finding have not yet been elucidated. It may be speculated that in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS.

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Section: Discussionmentioning

confidence: 99%

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association

et al. 2020

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“…[32][33][34] This concentration leads to a spectrum of common conditions, including OsgoodSchlatter disease (tibia tubercle apophysitis), 44 Sever disease (calcaneal apophysitis), 45 and Little League elbow (medial epicondyle apophysitis). 46 Physeal injuries such as Little League shoulder (proximal humeral physis) 47 and gymnast wrist (distal radius physis) 48 are also part of this spectrum of injury.…”

Section: Consequences Of Single Sport Specialization Physicalmentioning

confidence: 99%

Consequences of Single Sport Specialization in the Pediatric and Adolescent Athlete

Smucny

Parikh

Pandya

2015

Orthopedic Clinics of North America

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“…Although Osgood-Schlatter disease was described over 100 years ago (33), its exact etiology is still a disputed topic in the radiology literature. The depiction of this injury as representative of an osseous avulsion of a portion of the tibial tuberosity secondary to forceful contraction of the quadriceps muscle and subsequently the patellar tendon is still a matter of debate.…”

Section: Osgood-schlatter Diseasementioning

confidence: 99%

Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance

Gottsegen¹,

Eyer²,

White³

et al. 2008

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The knee is an intricate joint with numerous tendinous, ligamentous, and meniscal attachments, which make it particularly vulnerable to complex injuries after trauma. A variety of avulsion fractures of the knee can occur, including Segond and reverse Segond fractures; avulsions of the anterior and posterior cruciate ligaments; arcuate complex avulsion; iliotibial band avulsion; avulsions of the biceps femoris, semimembranosus, and quadriceps tendons; Sinding-Larsen-Johansson syndrome; and Osgood-Schlatter disease. These fractures often have a subtle appearance at conventional radiography, which is typically the first imaging modality performed in these cases. Advanced imaging modalities, particularly magnetic resonance imaging, are helpful and can provide valuable additional information for adequately defining the extent of damage. The onus is on the radiologist to identify the pattern of injury and to understand the substantial underlying damage that it frequently represents. Conveying this information to the referring clinician is crucial and represents the first step toward additional evaluation and probable orthopedic referral. By recognizing the significance of these injuries at initial presentation, radiologists can facilitate appropriate patient work-up and prevent the chronic morbidity associated with delayed treatment.

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Lesions of the Tibial Tubercle Occurring During Adolescence

Cited by 16 publications

References 0 publications

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association

Consequences of Single Sport Specialization in the Pediatric and Adolescent Athlete

Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance

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