胫骨结节骨软骨炎的诊疗进展  

Progress of diagnosis and treatment of Osgood-Schlatter disease

作　　者：郭艳波 梁延琛[2] 郑芳珑 张加豪 吕文学[2] 吴伟山 李刚 Guo Yanbo;Liang Yanchen;Zheng Fanglong;Zhang Jiahao;Lyu Wenxue;Wu Weishan;Li Gang(The First Clinical Medical School,Shandong University of Traditional Chinese Medicine,Ji'nan 250355,China;Department of Orthopaedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,济南250355 [2]山东中医药大学附属医院骨科,济南250014

出　　处：《中华骨科杂志》2023年第17期1186-1192,共7页Chinese Journal of Orthopaedics

基　　金：山东省自然科学基金(ZR2022MH171)。

摘　　要：胫骨结节骨软骨炎(Osgood-Schlatterdisease,OSD)是临床常见的青少年劳损性疾病,多见于青少年体育运动爱好者、运动员和军人。OSD临床表现典型,根据病史、体格检查和膝关节X线检查即可明确诊断,但需与其他可能导致膝前痛的疾病相鉴别。OSD发生的危险因素包括男性、男性12~15岁和女性8~12岁、高体质指数、骨骼肌肉解剖变异、运动量大等。OSD是一种自限性疾病,随着骨骼的成熟而逐渐痊愈。大部分患者无需治疗或也可采用运动疗法、药物及物理治疗等保守方法治疗,但可能遗留后遗症,影响运动功能和生活质量。临床上须充分重视,若保守治疗不佳应积极手术治疗,手术原则为清除骨碎片和胫骨结节成形。常见的手术方式包括传统开放手术和关节镜手术。关节镜手术具有微创、快速康复等优势,是目前提倡的最佳手术方式,但其中远期疗效尚不明确。Osgood-Schlatter disease(OSD)is a common strain disease in adolescents,which is more common in youth sports enthusiasts,athletes and soldiers.The clinical manifestations of OSD are typical,and the diagnosis can be made based on the medical history,physical examination and knee X-ray examination,but it needs to be differentiated from other diseases that may cause anterior knee pain.The risk factors of OSD development include males,12-15 years of age in males and 8-12 years of age in females,high body mass index,skeletal-muscular anatomical variants,and large amount of exercise,etc.OSD is a self-limited disorder that gradually resolves as the skeleton maturates.Most patients do not need treatment or can also be treated with conservative methods such as exercise therapy,medications and physical therapy,but may be left with sequelae that affect motor function and quality of life.Clinical attention should be paid to it adequately.If the conservative treatment is ineffective,active operation should be performed.The principle of operation is to remove bone fragments and reconstruct tibial tuberosity.Common surgical procedures include traditional open surgery and arthroscopic surgery.Arthroscopic surgery,with its advantages of minimally invasive and rapid recovery,is currently advocated as the best surgical procedure,but the mid-and long-term efficacy is unclear.

关 键 词：胫骨 骨软骨炎 诊断 治疗 综述 

分 类 号：R681[医药卫生—骨科学]