Bones are an important part of the musculoskeletal system and create the skeleton of the whole body. In case of damage to bones and joints, a person cannot normally move and care for himself, and he also risks becoming disabled. That is why, at the first signs of bone disease, you should immediately consult a doctor. Osteochondropathy of the tibial tuberosity is a serious pathology in which non-infectious inflammation and bone necrosis are manifested. The tuberosity, as a rule, is in its upper part, so during a disease a person experiences pain in the knee joint. In this article we will talk more about pathology, find out why it appears and how to treat it.
What it is?
Osteochondropathy of the tibial tuberosity is also called Osgood-Schlatter disease. Often it occurs at an early age, during the period of intensive growth of the child. At this point, an increase in bone mass occurs quite quickly, and blood vessels cannot develop at such a fast pace. Therefore, part of the bone is deficient in the substances necessary for normal development and oxygen starvation, and bone tissue becomes very fragile and easily injured.
With physical overload at an early age and constant microtrauma in the patella tendon, inflammation develops inside the tibial tuberosity and its necrosis. Ligament tearing and knee joint dysfunction are possible. Most often, pathology occurs in children involved in sports, but it can also occur due to domestic injuries.
It is noticed that boys suffer from osteochondropathy of the tibial tuberosity more often than girls. As a rule, both legs are affected at the same time, but the course of the disease is one-sided.
Why does the disease appear?
Experts identify a number of reasons involved in the manifestation of pathology:
- Hormonal disruptions.
- Genetic predisposition.
- Metabolic disorders (calcium and vitamins are poorly absorbed).
- The lack of interaction of bone tissue with blood vessels.
- Changes in blood flow.
- Frequent occurrence of microtrauma.
- The spine and limbs are in an unnatural position for a long time (it happens most often in athletes).
It is believed that the main factors leading to the onset of the disease are constant physical exertion, during which bone microtraumas and knee injuries (fractures, dislocations) occur.
Risk groups include children involved in sports with a heavy load on the legs, especially boys aged 11 to 15 years. Sports that increase the risk of Osgood-Schlatter disease include: football, hockey, volleyball, basketball, ballet, figure skating, gymnastics.
Approximately 15-20% of adolescents engaged in active physical activity suffer from this pathology. For non-professional athletes, this figure is much lower - only 3-5%.
Diagnosis of tibial tuberosity osteochondropathy
With the usual course and the presence of characteristic signs, the disease is easily diagnosed. To do this, the doctor only needs to examine the patient and find out the risk factors and characteristic complaints.
Radiography is used to confirm the diagnosis. In the pictures you can see the heterogeneous structure and increase in tibial tuberosity in size. In the case of fragmentation in the images, a fragment of the bone tissue with a visible fracture zone is noticeable.
If radiography did not help to make a diagnosis, resort to computed or magnetic resonance imaging. In some cases, ultrasound is required, as well as general and biochemical blood tests. The latter is used to exclude other types of diseases: often tuberosity is confused with rheumatoid arthritis.
Symptoms
Recognize osteochondropathy of the tibial tuberosity in children is possible by the following signs:
- the affected area swells, a swelling appears;
- pain just below the patella;
- thickening in the soft tissues;
- muscle tension surrounding the affected area;
- increased pain during physical exertion.
In the initial stages of the disease, uncomfortable sensations are observed only periodically, most often during running, walking or squats. The pain intensifies when the patient is in a kneeling position. Osteochondropathy of the tibial tuberosity does not cause tissue discoloration in the affected area and temperature increase. During exacerbations, changes in the anterior part of the lower leg can be observed, which can be noticed with a leg bent at the knee.
Treatment of tibial tuberosity osteochondropathy
Pathology is treated with the help of complex therapy. First of all, the patient is provided with immobility of the affected area and is forbidden to create a load on the leg. The use of retaining bandages and orthoses is recommended. In cases of severe disease, gypsum is applied to completely limit bone movement.
Also, physiotherapy and medications are included in the course of treatment, and after relieving pain and inflammation, physiotherapy exercises or massage procedures can be prescribed. In advanced cases, surgical intervention is used.
For osteochondropathy of the tibial tuberosity (ICD-10 - M92.5), non-steroidal anti-inflammatory drugs are used. They eliminate pain and relieve inflammation. As an additional treatment, UHF, electrophoresis, magnetotherapy, compresses with ozokerite and paraffin are used.
Physiotherapy exercises consist of exercises to strengthen the muscles of the lower leg and thigh. This prevents destruction and helps relieve stress on the knee joint. A therapeutic massage improves blood circulation in the affected area.
Operation
Surgical treatment is used in the following cases:
- osteochondropathy of the tibia of the right or left knee lasts more than two years;
- conservative treatment for a long time (9-12 months) does not bring the desired effect;
- the appearance of complications - tearing of the patella tendon or fragmentation of tuberosity;
- at the time of diagnosis, the patient is over 18 years old.
The operation itself is technically considered uncomplicated, but the recovery period can be quite long. Further joint function and success from surgery depend on the effectiveness of rehabilitation treatment.
ethnoscience
The use of traditional medicine during the treatment of osteochondropathy of the tibial tuberosity is not recommended. Such drugs cannot penetrate deeply and reach the bone tissue. In this regard, alternative therapy will not bring the desired effect. Optionally, you can take therapeutic baths or use lotions with herbs, as well as warming compresses, but only after consulting a doctor.
Forecast
When therapy is started on time, the prognosis for treating osteochondropathy is favorable: the bone is quickly restored. In the future, such consequences as the appearance of an externally noticeable bump on the knee, the appearance of painful sensations when the weather changes in the affected area are possible. Children who have had osteochondropathy of tuberosity are more susceptible to joint diseases in adulthood.
If you do not engage in treatment, the joint begins to gradually collapse, which inevitably leads to osteoarthritis. Pathology is accompanied by constant pain in the knee, and ends with disability.
Prevention
To avoid serious complications, certain preventive measures must be observed:
- Avoid too intense training;
- avoid overstrain of the affected leg;
- once a year to undergo an examination of an orthopedist, which will help to detect pathology in time;
- to strengthen the muscles of the legs every day you need to do therapeutic exercises;
- if you get a knee injury, be sure to consult a doctor;
- in order not to burden the knee even more, excess weight should be avoided, so the patient should eat right.
Conclusion
The disease is considered a fairly common ailment of the musculoskeletal system, which occurs mainly in adolescents and children. It is characterized by almost one hundred percent recovery and a benign course. It is important to identify the pathology in time and start therapy if necessary.
In order not to encounter Osgood-Schlatter disease, parents should control the physical activities of their child, which should correspond to his age and physical fitness.