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The disease Osgood-Schlatter is most commonly found in sports teenager growing up apophysose accounting for 28.4% of osteochondrosis by Breck. It relates to 62% of osteochondrosis knee and affects adolescent girls between 10 and 12 and boys between 12 and 15 It is usually considered a benign pathology that cures in the majority of cases. However, in 5-10% of cases there is persistent residual pain in adulthood.
The classic complication is the avulsion fracture of the tibial tuberosity in adolescents who continued his sports without restriction.
The possible consequences are numerous including the presence of a free bone fragment at the insertion of the tendon originally described by Osgood the establishment of a genu recurvatum, a high kneecap or patella alta and an enlarged tibial tuberosity (ATT) annoying sport.
The main two treatments are complete rest from sport activity or cast immobilization.
The main objective is to compare these two technics according to the proportion of full sporting recovering at 12 months
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cast immobilization | Experimental | 36 patients in the experimental cast immobilization |
|
| complete sport rest | Active Comparator | 36 patients in the complete sport rest group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cast immobilization group | Other | Patients in this group will have their knee locked with a resin going from the ankle to the top of the thigh for 4 weeks, followed by 4 weeks without cast but with rehabilitation through physiotherapy. |
| Measure | Description | Time Frame |
|---|---|---|
| Restarting a sporting activity | Comparison between the 2 groups of the proportion of patient returning to sports activity 12 weeks after treatment. | 12 weeks after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Anterior tibial tuberosity pain | Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation | Inclusion visit Day 0 |
| Anterior tibial tuberosity pain |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jean-Francois LUCCIANI, MD | Department of Sport's medicine, Hospital Edouard Herriot- Hospices Civils de Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Sport's medicine, Hospital Edouard Herriot- Hospices Civils de Lyon, 5 Place d'Arsonval | Lyon | 69003 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Result | Duperron L., Haquin A., Berthiller J., Chotel F., Pialat J-B., Luciani J-F. Étude d'une cohorte de 30 patients immobilisés avec une résine cruro-malléolaire pour une maladie d'Osgood-Schlatter. Science & Sports. 2016;31(6):323-335. doi:10.1016/j.scispo.2016.04.014. |
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| ID | Term |
|---|---|
| D055034 | Osteochondrosis |
| ID | Term |
|---|---|
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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| complete sport rest. | Other | Patients included in this group will follow the current standard procedure for this disease that is to say complete sport rest during 8 weeks including rehabilitation through physiotherapy, following the exact same technic as the experimental group . |
|
Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation
| follow-up visit week 4 |
| Anterior tibial tuberosity pain | Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation | follow-up visit week 8 |
| Anterior tibial tuberosity pain | Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation | follow-up visit week 12 |
| Pain killer consumption | Evaluation of pain killer consumption (type, dose ,frequency) between the 2 groups | follow-up visit week 4 |
| Pain killer consumption | Evaluation of pain killer consumption (type, dose ,frequency) between the 2 groups | follow-up visit week 8 |
| Quality of life assessment | Quality of life will be assessed using the SF-12 auto questionnaire | inclusion visit Day 0 |
| Quality of life assessment | Quality of life will be assessed using the SF-12 auto questionnaire | follow-up visit week 12 |
| Quality of life assessment | Quality of life will be assessed using the SF-12 auto questionnaire. As the standard follow-up visit are over, this questionnaire will be asked by phone | follow-up visit month 6 |
| Activity level assessment | Activity level will be assessed using the Tegner scale | inclusion visit Day 0 |
| Activity level assessment | Activity level will be assessed using the Tegner scale | follow-up visit week 12 |
| Activity level assessment | Activity level will be assessed using the Tegner scale. As the standard follow-up visit are over, this scale will be asked by phone | follow-up visit month 6 |
| complete sport rest compliance assessment | The complete sport rest compliance will be assessed using a visual analogic scale (0 to 10, 0 will be a complete rest compliance) | follow-up visit week 4 |
| painfulness due to immobilization cast | The patient in the cast immobilization group will be asked what was the level his/her level of cast tolerance: bad, average, good or very good. | follow-up visit week 12 |
| Quadricipital shortness | The Quadricipital shortness will be evaluated thanks to the knee flexion angle will be measured using the modified Thomas test as well as hamstring muscles length measured using the popliteal angle | inclusion visit Day 0 |
| Quadricipital shortness | The Quadricipital shortness will be evaluated thanks to the knee flexion angle will be measured using the modified Thomas test as well as hamstring muscles length measured using the popliteal angle | follow-up visit week 4 |
| Quadricipital shortness | The Quadricipital shortness will be evaluated thanks to the knee flexion angle will be measured using the modified Thomas test as well as hamstring muscles length measured using the popliteal angle | follow-up visit week 8 |
| Patella size | The patella size will be measure on the lateral radiograph using the Caton and Deschamp index | inclusion visit Day 0 |
| Patella size | The patella size will be measure on the lateral radiograph using the Caton and Deschamp index | follow-up visit week 8 |
| Radiographic evolution of Osgood Schlatter disease | Both clinicians and radiologist will evaluate separately the evolution of Osgood Schlatter disease using a new classification. It is based on 3 parameters: anterior tibial tuberosity fragmentation, thickening of soft tissues and presence or not of an ossicle. | follow-up visit week 12 |
| Potential return to sport activity | After a week of training, patients of each group will be evaluated and the clinician will consider the possibility of a potential return to sport activity the week 8 of follow-up | follow visit week 8 |
| Return to sport activity at the initial level | Six months after the intervention, patients will be called to evaluate if they were able to return to a sport activity at the same level they were before the disease. This proportion will be compared in between both groups | follow visit month 6 |
| alternative options during the study | Each patient will be ask during the phone interview at 6 months if the consulted another physicians or if they used an alternative to that proposed in our study. | follow visit month 6 |