Risk assessment of the onset of Osgood–Schlatter disease using kinetic analysis of various motions in sports

Abstract

BackgroundSome studies have listed motions that may cause Osgood-Schlatter disease, but none have quantitatively assessed the load on the tibial tubercle by such motions.PurposesTo quantitatively identify the load on the tibial tubercle through a biomechanical approach using various motions that may cause Osgood-Schlatter disease, and to compare the load between different motions.MethodsEight healthy male subjects were included. They conducted 4 types of kicks with a soccer ball, 2 types of runs, 2 types of squats, 2 types of jump landings, 2 types of stops, 1 type of turn, and 1 type of cutting motion. The angular impulse was calculated for knee extension moments ≥1.0 Nm/kg, ≥1.5 Nm/kg, ≥2.0 Nm/kg, and ≥2.5 Nm/kg. After analysis of variance, the post-hoc test was used to perform pairwise comparisons between all groups.Results/ConclusionsThe motion with the highest mean angular impulse of knee extension moment ≥1.0 Nm/kg was the single-leg landing after a jump, and that with the second highest mean was the cutting motion. At ≥1.5 Nm/kg, ≥2.0 Nm/kg, and ≥2.5 Nm/kg, the cutting motion was the highest, followed by the jump with a single-leg landing. They have a large load, and are associated with a higher risk of developing Osgood-Schlatter disease. The mean angular impulse of the 2 types of runs was small at all the indicators.Clinical relevanceMotions with a high risk of developing Osgood-Schlatter disease and low-risk motions can be assessed in further detail if future studies can quantify the load and number of repetitions that may cause Osgood-Schlatter disease while considering age and the development stage. Scheduled training regimens that balance load on the tibial tubercle with low-load motions after a training day of many load-intensive motions may prevent athletes from developing Osgood-Schlatter disease and increase their participation in sports.

Therapeutic interventions in Osgood-Schlatter disease

“…These factors can be considered to generate not only OSD, but also its bilateral form in the analyzed case. This thesis corresponds to the findings of Itoh et al, [ 19 ] who argued that movements that significantly stress the lower limb, such as kicking (in football) and 1-legged landing are associated with a higher risk of developing OSD, although these studies were conducted in male athletes.…”

Characteristics of the Kicking Motion in Adolescent Male Soccer Players Who Develop Osgood-Schlatter Disease: A Prospective Study

“… 2 Moreover, the fast knee extension of the support leg at ball impact may have increased the traction stress of the tibial tubercle through the quadriceps femoris muscle and resulted in OSD of the support leg. Additionally, Itoh et al 11 revealed that single-leg landing produced the highest knee extension moment compared with other motions during soccer training. Moreover, the knee extension moment of the support leg during the kicking motion is predicted to be higher than that during running or cutting.…”

“… 26 Additionally, higher knee extension moments are seen during a single-leg landing compared with other motions (eg, running or cutting motion) in soccer. 11 …”

“…26 Additionally, higher knee extension moments are seen during a single-leg landing compared with other motions (eg, running or cutting motion) in soccer. 11 The kicking motion may contribute to OSD onset in the support leg because soccer players reportedly prefer 1 leg for ball kicking, which generates asymmetric lower extremity loading patterns. 8 However, whether the soccer kicking motion itself is related to OSD onset in the support leg remains unclear.…”

Torsional deformities and overuse injuries: what does the literature tell us

“…The traction force applied by the patellar tendon to the tibial tubercle apophysis has never been measured experimentally. Itoh et al were the first to estimate the The influence of malalignment on overuse injuries force on the tibial tubercle through gait analysis and musculoskeletal modelling (39). The authors analyzed the knee extension moment in eight patients, during the two most common activities (soccer and basketball) considered as involved in the development of OSD.…”