1
|
Krommes K, Thorborg K, Clausen MB, Rathleff MS, Olesen JL, Kallemose T, Hölmich P. Self-management including exercise, education and activity modification compared to usual care for adolescents with Osgood-Schlatter (the SOGOOD trial): protocol of a randomized controlled superiority trial. BMC Sports Sci Med Rehabil 2024; 16:89. [PMID: 38643184 PMCID: PMC11032598 DOI: 10.1186/s13102-024-00870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/25/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Osgood-Schlatter is the most frequent growth-related injury affecting about 10% of physically active adolescents. It can cause long-term pain and limitations in sports and physical activity, with potential sequela well into adulthood. The management of Osgood-Schlatter is very heterogeneous. Recent systematic reviews have found low level evidence for surgical intervention and injection therapies, and an absence of studies on conservative management. Recently, a novel self-management approach with exercise, education, and activity modification, demonstrated favorable outcomes for adolescents with patellofemoral pain and Osgood-Schlatter in prospective cohort studies. AIM The aim of this trial is to assess the effectiveness of the novel self-management approach compared to usual care in improving self-reported knee-related function in sport (measured using the KOOS-child 'Sport/play' subscale) after a 5-month period. METHODS This trial is a pragmatic, assessor-blinded, randomized controlled trial with a two-group parallel arm design, including participants aged 10-16 years diagnosed with Osgood-Schlatter. Participants will receive 3 months of treatment, consisting of either usual care or the self-management approach including exercise, education, and activity modification, followed by 2 months of self-management. Primary endpoint is the KOOS-child 'Sport/play' score at 5 months. This protocol details the planned methods and procedures. DISCUSSION The novel approach has already shown promise in previous cohort studies. This trial will potentially provide much-needed level 1 evidence for the effectiveness of the self-management approach, representing a crucial step towards addressing the long-term pain and limitations associated with Osgood-Schlatter. TRIAL REGISTRATION Clinicaltrials.gov: NCT05174182. Prospectively registered December 30th 2021. Date of first recruitment: January 3rd 2022. Target sample size: 130 participants.
Collapse
Affiliation(s)
- Kasper Krommes
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark.
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice at Aalborg University, Aalborg. Fyrkildevej 7, DK-9220, Aalborg, Denmark
- Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
| | - Jens Lykkegaard Olesen
- Center for General Practice at Aalborg University, Aalborg. Fyrkildevej 7, DK-9220, Aalborg, Denmark
| | - Thomas Kallemose
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark
- Department of Clinical Research, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Alle 30, Hvidovre, DK-2610, Danmark
| | - Per Hölmich
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| |
Collapse
|
2
|
Hansen R, Rathleff MS, Lundgaard-Nielsen M, Holden S. The development of an informative leaflet for children and adolescents suffering from Osgood-Schlatter disease. Scand J Med Sci Sports 2023; 33:2608-2612. [PMID: 37726948 DOI: 10.1111/sms.14498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 08/07/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
The mainstay in the treatment of Osgood-Schlatter Disease (OSD) is guidance on activity modification alongside exercises. The purpose of this study was to create an informative leaflet for patients with OSD, based on evidence and stakeholders perspectives. A synthesis of the literature, including national reference work, clinical research, and systematic reviews informed the initial leaflet. Twelve children with OSD and four clinical experts provided feedback through semi-structured interviews. After incorporating stakeholder input, the leaflet 'Osgood-Schlatter-Information and guidance' was developed. This provides a resource to assist the provision of information and translation of the current evidence.
Collapse
Affiliation(s)
- Rudi Hansen
- Department of Physical and Occupational Therapy, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Mathilde Lundgaard-Nielsen
- Department of Physical and Occupational Therapy, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Sinead Holden
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
3
|
Yazdi H, Motaghi P, Ghaderi MT. Knee Flexion Deformity and Increased Posterior Tibial Slope Associated with Osgood Schlatter Disease: A Case Report and Review of Literature. Arch Bone Jt Surg 2023; 11:72-76. [PMID: 36793666 PMCID: PMC9903304 DOI: 10.22038/abjs.2022.60141.2965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/14/2022] [Indexed: 02/17/2023]
Abstract
Genu recurvatum associated with Osgood-Schlatter disease (OSD) has been reported in several studies. In this report, we describe a rare complication of a case of OSD with flexion contracture (tfighat is the exact opposite of the knee deformity classically associated with OSD) and increased posterior tibial slope. In the current article, we report a 14-year-old case of OSD referred to our center with a fixed knee flexion contracture. Radiographic evaluation revealed a tibial slope of 25 degrees. There was no limb length discrepancy. Bracing that was prescribed in the primary center before referring to us was not successful in treating this deformity. He underwent anterior tibial tubercle epiphysiodesis surgery. After a year, the flexion contracture of the patient was significantly reduced. The tibial slope decreased by 12 degrees and reached 13 degrees. The present report suggests that OSD may affect the posterior tibial slope and lead to knee flexion contracture. Surgical epiphysiodesis can correct the deformity.
Collapse
Affiliation(s)
- Hamidreza Yazdi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Paniz Motaghi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taher Ghaderi
- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Midtiby SL, Wedderkopp N, Larsen RT, Carlsen AMF, Mavridis D, Shrier I. Effectiveness of interventions for treating apophysitis in children and adolescents: protocol for a systematic review and network meta-analysis. Chiropr Man Therap 2018; 26:41. [PMID: 30386556 PMCID: PMC6198434 DOI: 10.1186/s12998-018-0209-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/13/2018] [Indexed: 12/01/2022] Open
Abstract
Background Overuse injuries are reported to be more common than acute trauma in children and adolescents, causing pain and reduced function. The most common is apophysitis - a traction injury to the apophysis in growing individuals. The duration of symptoms reported in the literature is between 6 weeks to 6 months or more. The objective of this systematic review and network meta-analysis is to compare the effectiveness and safety of all available treatments for any type of apophysitis in children and adolescents. Methods/Design We will conduct a systematic review to retrieve all relevant studies applying a comparative design. Searches will be made in the Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and SportDiscus databases and via reference searching. The efficacy of treatments will be compared with respect to the outcomes 1) time to pain-free activity and 2) risk of subsequent injury. Risk of bias assessment will be made using revised tool for assessing risk of bias in randomized trials for Randomized trials and Robins-I tool for non-randomized trials. We will explore if different treatment comparisons are sufficiently similar in terms of effect modifiers (transitivity assumption) with the aim to conduct network meta-analyses for randomized and non-randomized studies separately. A treatment hierarchy will be obtained using the surface under the cumulative ranking curve (SUCRA) and mean ranks, visualized using rankograms. We will use the CINeMA software to apply the modified version of Grades of Recommendation, Assessment, Development and Evaluation (GRADE), developed specifically to evaluate the quality of evidence in network meta-analysis. Discussion To date the comparative effects of interventions for apophysitis seem to rely mainly on expert opinion. We aim to identify all comparative treatment designs described in the literature and synthesize data when possible. We will use the estimated treatment effects between injury locations to provide guidance in managing apophysitis. Trial registration PROSPERO ID number: CRD42018083746. Electronic supplementary material The online version of this article (10.1186/s12998-018-0209-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Stig L Midtiby
- 1Department of Physiotherapy, University College Lillebaelt, Niels Bohrs Allé 1, 5230 Odense, SE Denmark
| | - Niels Wedderkopp
- Department of Regional Health Research, University of Southern, Copenhagen, Denmark.,Orthopedic department, Hospital of South Western Denmark, Esbjerg, Denmark
| | - Rasmus T Larsen
- 3Copenrehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Fiala Carlsen
- 1Department of Physiotherapy, University College Lillebaelt, Niels Bohrs Allé 1, 5230 Odense, SE Denmark
| | - Dimitris Mavridis
- 4Department of Primary Education, University of Ioannina, Ioannina, Greece
| | - Ian Shrier
- 5Centre for Clinical Epidemiology, Jewish General Hospital, McGill University, Ottawa, Canada
| |
Collapse
|
5
|
Abstract
Growing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. This review covers common disorders affecting the hip, the knee and the foot. The aim is to assist general practitioners in recognising developmental norms and differentiating physiological from pathological conditions and to identify when a specialist referral is necessary.
Collapse
Affiliation(s)
- Ashlee M Dobbe
- Department of Orthopaedics, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Paul J Gibbons
- Department of Orthopaedics, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| |
Collapse
|