The Passive Mechanical Properties of Muscles and Tendons in Children Affected by Osgood-Schlatter Disease

Abstract

Background: Osgood-Schlatter disease (OSD) is a sports-related disorder involving apophysitis, which affects the tibial tuberosity. The identification of factors related to OSD is important for its prevention and early recovery from the disease. This study aimed to compare the passive mechanical properties of the muscle-tendon unit in children affected by an OSD and healthy children, by using ultrasound real-time tissue elastography. Methods: Eighteen legs affected by OSD (OSD group) and 42 healthy legs (control: CON group) were assessed. The elasticity was obtained from the quadriceps muscles and patella tendon (PT) using real-time tissue elastography. The strain ratio (SR; muscle or tendon/reference ratio: strain rate of the muscle or tendon divided by that of the reference material) was calculated as an indicator of the elasticity of the tissue of interest. Results: The SR of the PT in the OSD group was significantly lower than that in the CON group (P<0.05). We found no significant difference between the groups in terms of the SR value of all muscles (P>0.05). Conclusions: The results suggest that a PT with a lower SR may be associated with an OSD and that the passive mechanical properties of the quadriceps muscles have limited association with an OSD. Levels of Evidence: Level IV.

A systematic review of imaging findings in patients with Osgood‐Schlatter disease

“…Of the 40 studies included, 25 studies reported on OSD‐related imaging findings 4‐7,9,11‐30 . Most studies used radiography (n = 10) or US (n = 6), with the remaining studies using radiography and US (n = 4), radiography and MRI (n = 3), MRI only (n = 1) and one study using both CT, MRI, radiography, and bone scintigraphy (n = 1).…”

“…Eight cross‐sectional 4,15,20,24,27‐30 and two case‐control studies 6,7 reported on OSD imaging findings compared to controls. In the studies that included a control group, the imaging findings described above (Table 1) were not observed in the controls without OSD 4,7,15,27 .…”

Prevention of strain‐induced impairments of patellar tendon micromorphology in adolescent athletes

“…Symptomatic athletes were included if they confirmed that maximum strength testing was possible. One athlete diagnosed with Osgood‐Schlatter disease was excluded from the analysis of pain, yet muscle and tendon data were included considering no evident reductions in training participation and the apparent lack of disease‐related changes of tendon mechanical properties 23 . The participants and their legal guardians gave written informed consent to the experimental procedures, which were approved by the ethics committee of the Humboldt‐Universität zu Berlin (vote from 16.02.2018) and carried out in accordance with the declaration of Helsinki.…”

Muscle Ultrasonographic Elastography in Children: Review of the Current Knowledge and Application

“…On the basis of real-time tissue elastography results of the rectus femoris muscles in 37 teenage male athletes, Enomoto et al rejected the hypothesis that one of the factors that lead to Osgood-Schlatter disease is higher-than-normal muscle stiffness. No significant difference in quadriceps muscle stiffness was found between the OGD and healthy groups [2].…”

“…Thus, a new, non-invasive, affordable, and objective test is urgently needed. We believe that elastography may prove to be such a tool in the future, as it has already been applied in hepatological, endocrinal, and oncological diagnostics [1,2]. Although far more studies on muscle elastography have been conducted in the adult population than in children, results from the former cannot be simply applied to the latter.…”