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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
72
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.
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 .
Department of Sport's medicine, Hospital Edouard Herriot- Hospices Civils de Lyon, 5 Place d'Arsonval
Lyon, France
Restarting a sporting activity
Comparison between the 2 groups of the proportion of patient returning to sports activity 12 weeks after treatment.
Time frame: 12 weeks after intervention
Anterior tibial tuberosity pain
Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation
Time frame: Inclusion visit Day 0
Anterior tibial tuberosity pain
Mean pain evaluation using Visual analogic scale between the 2 groups, at Anterior tibial tuberosity palpation
Time frame: 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
Time frame: 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
Time frame: follow-up visit week 12
Pain killer consumption
Evaluation of pain killer consumption (type, dose ,frequency) between the 2 groups
Time frame: follow-up visit week 4
Pain killer consumption
Evaluation of pain killer consumption (type, dose ,frequency) between the 2 groups
Time frame: follow-up visit week 8
Quality of life assessment
Quality of life will be assessed using the SF-12 auto questionnaire
Time frame: inclusion visit Day 0
Quality of life assessment
Quality of life will be assessed using the SF-12 auto questionnaire
Time frame: 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
Time frame: follow-up visit month 6
Activity level assessment
Activity level will be assessed using the Tegner scale
Time frame: inclusion visit Day 0
Activity level assessment
Activity level will be assessed using the Tegner scale
Time frame: 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
Time frame: 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)
Time frame: 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.
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: follow-up visit week 8
Patella size
The patella size will be measure on the lateral radiograph using the Caton and Deschamp index
Time frame: inclusion visit Day 0
Patella size
The patella size will be measure on the lateral radiograph using the Caton and Deschamp index
Time frame: 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.
Time frame: 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
Time frame: 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
Time frame: 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.
Time frame: follow visit month 6
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