MUSCULOSKELETAL SURGERY最新文献

{"title":"The myth of the ankle centre of rotation: definitions, misconceptions and clinical implications.","authors":"Vincenzo Leone, Antonio Mazzotti, Simone Ottavio Zielli, Cesare Faldini","doi":"10.1007/s12306-026-00977-2","DOIUrl":"https://doi.org/10.1007/s12306-026-00977-2","url":null,"abstract":"<p><p>The ankle joint complex is a sophisticated structure whose kinematic behaviour is frequently oversimplified in both clinical and biomechanical practice. The hinge model, with a fixed axis aligned with the line joining medial and lateral malleoli, remains prevalent despite evidence of a migrating centre of rotation (COR) and three-dimensional motion. This paper addresses common misconceptions surrounding the COR and axis of rotation (AOR) at the ankle joint, clarifying their purely kinematic nature. A conceptual framework is provided, introducing mechanical notions of COR, centrode, helical axis and axode with reference to their application in the ankle joint analysis. The clinical relevance of accurate COR localisation is discussed, spanning the topics of muscles moment arm estimation and total ankle arthroplasty (TAA). Current limitations are critically reviewed, including the absence of standardised in vivo protocols and the insufficient integration of subject-specific kinematic assessment. Emerging acquisition technologies are proposed as the most promising avenue to bridge the gap between biomechanical knowledge and clinical translation, ultimately moving beyond the oversimplified single-axis model in the management of ankle pathology.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do surgical technique and pin configuration influence clinical and radiological outcomes in pediatric supracondylar humerus fractures? a modified Flynn-based analysis.","authors":"R Arıkan, K Öner, F Karaca","doi":"10.1007/s12306-026-00971-8","DOIUrl":"https://doi.org/10.1007/s12306-026-00971-8","url":null,"abstract":"<p><strong>Background: </strong>Pediatric supracondylar humerus fractures are among the most common elbow injuries in childhood. Although K-wire fixation is widely accepted, the optimal surgical technique and pin configuration remain controversial. Additionally, the Modified Flynn criteria, which assess both functional and cosmetic outcomes, have been less frequently utilized in the literature.</p><p><strong>Aim: </strong>This study aimed to evaluate whether surgical technique and pin configuration influence clinical and radiological outcomes in pediatric supracondylar humerus fractures using Modified Flynn criteria.</p><p><strong>Methods: </strong>This retrospective study included 78 pediatric patients who underwent surgical treatment for supracondylar humerus fractures between 2012 and 2021. Patients were categorized according to surgical technique (open vs. closed reduction) and pin configuration (lateral-only vs. medial-lateral fixation). Radiological parameters, including Baumann angle, carrying angle, and humerocapitellar angle, were assessed. Functional and cosmetic outcomes were evaluated using the Modified Flynn criteria. Range of motion was compared with the contralateral side. Statistical analyses were performed using SPSS, with p < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Closed reduction was associated with a significantly shorter hospital stay compared to open reduction (p < 0.001). Gartland type II fractures demonstrated significantly shorter pin removal times than type III and IV fractures (p = 0.036). No significant differences were observed between surgical techniques or pin configurations in terms of radiological parameters or Modified Flynn functional and cosmetic outcomes (p > 0.05). According to the Modified Flynn cosmetic score, carrying angle and supination differed significantly between excellent and good outcome groups (p = 0.002 and p < 0.001, respectively). Based on the Modified Flynn functional score, flexion-extension arc and supination were significantly different between excellent-good and fair-poor outcome groups (p < 0.001 and p = 0.003, respectively). All observed nerve injuries resolved during follow-up, consistent with neuropraxia.</p><p><strong>Conclusion: </strong>No significant differences were observed between lateral-only and crossed pin fixation regarding clinical, radiological, or Modified Flynn outcomes in this retrospective study. Both fixation methods provided satisfactory clinical and radiological outcomes when stable fracture reduction was achieved. These findings suggest that the choice of pin configuration should be individualized according to fracture characteristics and intraoperative stability rather than applied routinely. Larger prospective studies are warranted to confirm these findings.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The «SPA-CE» classification for glenoid bone loss in reverse shoulder arthroplasty: a CT-based analysis of 211 shoulders.","authors":"D A Samkovich, G A Airapetov, V F Naidanov, I A Dmitrov, A P Prizov, A R Abasov, A A Daniliyants","doi":"10.1007/s12306-026-00975-4","DOIUrl":"https://doi.org/10.1007/s12306-026-00975-4","url":null,"abstract":"<p><strong>Background: </strong>Glenoid bone loss represents a major challenge in primary reverse shoulder arthroplasty (RSA), directly influencing implant fixation, positioning, and reconstructive strategy. Existing classification systems describe glenoid morphology but do not provide a unified framework for treatment-oriented decision-making. The SPA-CE classification was developed as a CT-based system integrating defect depth, location, and version abnormality.</p><p><strong>Methods: </strong>A retrospective analysis of 211 consecutive primary RSA procedures was performed. Preoperative CT scans were used to classify glenoid morphology according to the SPA-CE system and the Walch classification. Reconstructive strategies were analyzed in relation to SPA-CE types. The distribution of morphologic patterns and their association with surgical techniques and underlying diagnosis were assessed.</p><p><strong>Results: </strong>The most common SPA-CE pattern was simple central (SC), observed in 62.1% of cases. Overall, simple (S) defects predominated (75.4%), whereas plastic (P) defects accounted for 24.2% and advanced (A) defects were rare (0.5%). Defects managed without structural reconstruction (SC and SEI) accounted for 73.9% of shoulders, whereas 1.4% required version correction without lateralization (SEII), 24.2% required lateralization (plastic types), and 0.5% required patient-specific reconstruction. A consistent relationship was observed between SPA-CE types and reconstructive strategies. In contrast, substantial variability in SPA-CE patterns was identified within individual Walch groups, particularly in Walch B2 glenoids. Underlying diagnosis influenced defect morphology: post-traumatic conditions, fractures, and rotator cuff tears were predominantly associated with SC defects, whereas osteoarthritis demonstrated the widest distribution of SPA-CE patterns, including complex and reconstructively demanding defects.</p><p><strong>Conclusion: </strong>The SPA-CE classification provides a structured, CT-based, and treatment-oriented framework for the assessment of glenoid bone loss in RSA. It demonstrates a consistent relationship with reconstructive strategies and may improve preoperative planning and surgical decision-making.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting need for and effect of external fixation in closed ankle fractures: a retrospective case-control study.","authors":"J Lynch-Larkin, A Powell, H Ingoe, J Sharr","doi":"10.1007/s12306-026-00966-5","DOIUrl":"https://doi.org/10.1007/s12306-026-00966-5","url":null,"abstract":"<p><strong>Objectives: </strong>To compare outcomes between planned and delayed ex-fix and identify predictors for requiring external fixation for closed ankle fractures.</p><p><strong>Methods: </strong>Design: Retrospective case-control study.</p><p><strong>Setting: </strong>Single trauma centre. Patient selection criteria: Skeletally mature patients with closed ankle fractures, with or without dislocation, temporised in cast or external fixation (ex-fix) (< 24 versus > 24 h), treated with open reduction/internal fixation. Outcome Measures and Comparisons: Planned (≤ 24 h from admission) or delayed (> 24 h) patients were compared in terms of time to definitive fixation, length of stay (LOS), and complications. A control cohort of cast-only patients with identical AO/OTA fracture patterns was identified to evaluate predictors of requiring ex-fix. Initial radiographs were analysed for talar displacement, posterior malleolar fragment (PMF) size, and number of reduction attempts.</p><p><strong>Results: </strong>Seventy-one patients underwent external fixation (25 planned, 46 delayed). Planned ex-fix was associated with significantly shorter time from admission to definitive fixation (7.8 vs 11.7 days, p < 0.0001) and reduced LOS (11.2 vs 16.6 days, p = 0.0037) compared with delayed ex-fix. Complication rates did not differ significantly between groups. Compared with controls, patients requiring delayed ex-fix demonstrated greater talar displacement on AP and lateral radiographs (p = 0.02 and p = 0.001, respectively). A PMF size ≥ 23% (OR 5.74, p = 0.0002) and two or more reduction attempts (OR 4.68, p = 0.0022) were independently associated with the need for external fixation.</p><p><strong>Conclusions: </strong>Planned external fixation in closed ankle fractures is associated with shorter hospital stay and earlier definitive fixation compared with delayed application. Significant talar displacement, larger posterior malleolar fragments, and multiple failed reduction attempts may help identify fractures that would benefit from planned external fixation.</p><p><strong>Level of evidence: </strong>Therapeutic and Diagnostic Level III.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative management of ipsilateral clavicle and scapula fractures in adults: a retrospective study.","authors":"L Lucenti, M D Castiglione, M A Musumeci, A Vescio, G Rovere, G Sciacca, G Testa, F Bosco, L Camarda, F M C Panvini, V Pavone","doi":"10.1007/s12306-026-00968-3","DOIUrl":"https://doi.org/10.1007/s12306-026-00968-3","url":null,"abstract":"<p><strong>Background: </strong>Concomitant ipsilateral clavicle and scapula fractures are uncommon injuries, and their optimal management remains controversial. While surgical treatment has been advocated for selected unstable patterns, the role of conservative treatment, particularly in minimally displaced fractures, has not been clearly established. The aim of this study was to evaluate the prevalence of concomitant clavicle and scapula fractures and to compare the clinical outcomes of conservatively treated patients with those of a matched cohort of patients with isolated clavicle fractures.</p><p><strong>Methods: </strong>We retrospectively reviewed all adult patients treated conservatively for clavicle fractures at our institution between January 2020 and December 2022. After applying the inclusion and exclusion criteria, 84 patients were included in the final analysis. Nine patients (10.7%) presented with a concomitant ipsilateral scapular fracture and constituted the study group. A 1:1 matched control group of patients with isolated clavicle fractures was selected according to age, sex, fracture location, and injured side. Clinical outcomes were assessed at a minimum follow-up of one year using the Constant-Murley Score, the University of California, Los Angeles (UCLA) Shoulder Score (expressed as a percentage of the maximum obtainable score), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, shoulder range of motion, and muscle strength.</p><p><strong>Results: </strong>The mean age of the study group was 53.3 ± 20.1 years. Three patients presented with a floating shoulder injury. Conservative treatment consisted of immobilization using either a figure-of-eight bandage or an arm sling followed by progressive rehabilitation. At final follow-up, patients with combined clavicle and scapula fractures achieved a mean Constant-Murley Score of 91.0 ± 4.5, a mean UCLA Shoulder Score of 91.3 ± 4.7%, and a mean DASH score of 4.65 ± 2.08. No statistically significant differences were found between the study group and the matched control group for any functional outcome measure, shoulder range of motion, or muscle strength (all p > 0.05).</p><p><strong>Conclusions: </strong>In this retrospective cohort, the presence of an undisplaced or minimally displaced ipsilateral scapular fracture did not significantly influence the clinical outcomes of conservatively treated clavicle fractures. Conservative management appears to provide satisfactory functional results in carefully selected patients; however, larger prospective studies are required to confirm these findings.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deltoid ligament repair is not necessary in patients with bimalleolar equivalent ankle fractures.","authors":"Jad Mansour, Mohammad Daher, Matthew Nakouzi, Amer Sebaaly, Alan H Daniels, Michel Estephan","doi":"10.1007/s12306-026-00967-4","DOIUrl":"https://doi.org/10.1007/s12306-026-00967-4","url":null,"abstract":"<p><p>Previous meta-analyses have shown that systematic deltoid repair (DR) in patients with bimalleolar equivalent ankle fractures improves post-operative functional outcomes and reduces reoperations. However, these studies were retrospective and are subject to the biases inherent in the nature of observational studies. Therefore, by including only randomized controlled trials (RCTs), this meta-analysis will assess the benefits of DR in these patients. Following the PRISMA guidelines, PubMed, Embase, Cochrane, and Google Scholar were accessed and explored until November 2025. The extracted data consisted of the risk of complications, post-operative and improvement in medial clear space (MCS), operative time, post-operative pain and post-operative American Orthopedic Foot and Ankle Society (AOFAS) score. Five RCTs were included, consisting of 244 patients, with 121 in the DR group and 123 in the control group. There was no difference between the two groups in adverse events. In addition, there were no differences in post-operative MCS, pain, or AOFAS between the two groups. However, the control group had a shorter operative time (Mean Difference = 46.75 min, p = 0.05). The results of this meta-analysis revealed that systematic DR did not have additional benefits in patients with bimalleolar equivalent ankle fractures. Future studies are needed in order to figure out the characteristics of patients that benefit from DR in this type of ankle fractures.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic versus intraoperative image-based navigated thoraco-lumbar pedicle screw fixation: a systematic review and meta-analysis.","authors":"G F Papalia, N Nardi, G Maltese, G Marcello, N Fazzi, F Russo, G Vadalà, R Papalia, V Denaro","doi":"10.1007/s12306-026-00965-6","DOIUrl":"https://doi.org/10.1007/s12306-026-00965-6","url":null,"abstract":"<p><strong>Purpose: </strong>Spondylodesis is performed to stabilize and immobilize spinal regions impacted by conditions such as degenerative disorders, deformities, trauma, tumors, or infections. To improve the accuracy of pedicle screw placement, computer-assisted navigation systems were introduced in spine surgery. The objective of this study was to compare the accuracy of pedicle screw placement and the patient outcomes in robotic-guided versus intraoperative 3D navigation techniques for thoraco-lumbar spine surgery.</p><p><strong>Methods: </strong>The search was conducted on 30 September 2025 on Scopus, Cochrane Central Library and PubMed. Prospective and retrospective studies that compared pedicle screw placement, clinical outcomes and complications using robotic versus intraoperative 3D navigation technique in the thoracolumbar segment were included. Hospital stay, operative time and blood loss were evaluated as continuous outcomes with mean difference. Screw accuracy, FJV, intraoperative and postoperative screw revisions, complications and complications were evaluated as dichotomous outcomes with odds ratio. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Among the 14 studies included in the meta-analysis, statistically significant results in favor of robotic group were described for hospital stay (p = 0.003) and pedicle screw accuracy (p < 0.00001). However, no significant differences were observed in terms of intraoperative or postoperative screw revisions, facet joint violations, operative time and blood loss.</p><p><strong>Conclusion: </strong>Robotic-guided pedicle screw fixation represents a safe and highly effective technique, showing statistically significant superiority in screw placement accuracy compared to CT-guided navigation.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photodynamic bone stabilization: a novel approach to elderly metastatic patients.","authors":"R Totti, F Cavola, R M Comodo, A El Motassime, G Bocchino, O El Ezzo, A Ziranu, G Maccauro, R Vitiello","doi":"10.1007/s12306-026-00964-7","DOIUrl":"https://doi.org/10.1007/s12306-026-00964-7","url":null,"abstract":"<p><p>Treatment of metastatic bone fractures could be challenging, especially in elderly oncologic patients. Recent treatment options like photodynamic nailing are a mini-invasive procedure that allows fractures stabilization and early recovery. We reviewed five studies following the PRISMA guidelines obtaining 148 patients treated with Photodynamic Bone Stabilization (PBS). Mean follow-up period after surgery was 10.5 months as reported in 4 of 5 studies (range 1.5-24 months). All patients evaluated have been treated due to metastasis from other primary tumors. IlluminOss® System demonstrated positive outcomes in the reviewed studies, decreasing mean VAS score from pre-surgery values (7.71) to post-surgery values (4.19). As reported in 3 of 5 studies evaluated, mean preoperatively MSTS score was 30.38% (27-40%), earliest postoperative MSTS was 61.59% (52-87.8%). Complications were reported in 27 patients (18.24%). Several complications were described: device rupture, thromboembolic events, aseptic dehiscence, and malunion, respectively, in 14 patients (9.45%), 3 patients (2.02%), 2 patients (1.35%), 2 patients (1.35%). Our analysis offers a preliminary overview of the outcomes and complications related to PDNs (IlluminOss® System). While classical intramedullary nailing is often linked to favorable functional outcomes, the risk of complications, such as: hardware failure, and the necessity for future hardware removal, should not be ignored. The results obtained from this analysis are promising; however, further randomized studies will be necessary to determine the superiority of the method over current treatments.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical timing beyond the 48-h guideline in elderly hip fractures: a retrospective evaluation of clinical and functional outcomes in 314 cases.","authors":"Antonio Vadalà, Francesco Suraci, Cristiano Benelli, Giulia Rescigno, Elisa Lamberti, Carola Morini, Giorgio Baldassari, Nicola Maffulli","doi":"10.1007/s12306-026-00960-x","DOIUrl":"10.1007/s12306-026-00960-x","url":null,"abstract":"<p><p>To evaluate the impact of surgical timing on mortality and functional outcomes in elderly patients with proximal femoral fractures (PFFs), specifically investigating whether a 72-h threshold provides a more sensitive clinical discriminator than the traditional 48-h guideline. A retrospective cohort study was conducted on 314 patients aged ≥ 65 years surgically treated for low-energy PFF (AO/OTA 31-A and B) between January 2018 and December 2019. Patients were initially dichotomized by a 48-h threshold (Group A ≤ 48 h, n = 139; Group B > 48 h, n = 175) and subsequently analyzed using a 72-h cutoff. Primary endpoints were 3-month and 1-year mortality. Multivariate logistic regression was performed to adjust for age, sex, and Charlson Comorbidity Index (CCI). Secondary outcomes included postoperative length of stay (LOS), transfusion requirements, and functional recovery assessed via the Barthel Index. No statistically significant difference in 3-month mortality was observed using the 48-h cutoff (Group A: 11.6% vs. Group B: 12.3%; p > 0.05). Conversely, the 72-h threshold emerged as a significant independent predictor of mortality (p < 0.05). Mortality rates for patients operated beyond 72 h were significantly higher at both 3 months (21.2% vs. 9.2%; p < 0.05) and 1 year (25.6% vs. 19.4%). Multivariate analysis confirmed surgical delay > 72 h as an independent risk factor (OR 2.1; 95% CI 1.3-3.4). The highest risk was observed in males aged > 85 years with extracapsular fractures operated beyond 72 h (1-year mortality: 37.5%). Mean LOS was significantly shorter in the early surgery group (7.6 ± 2.1 vs. 8.4 ± 2.8 days; p = 0.044). No significant differences were found in 3-month functional recovery between groups. In a real-world clinical setting, the 72-h threshold represents a critical \"red line\" for survival in elderly hip fracture patients. While striving for stabilization within 48 h remains ideal, maximum priority should be shifted toward preventing organizational delays that push vulnerable patients, particularly elderly males with extracapsular patterns, beyond the third day.Level of evidence: Level III (Retrospective cohort study).</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive management of the adolescent athlete with osgood-schlatter disease: a multidimensional approach.","authors":"D Colmenares-Bonilla, J Solis-Pena","doi":"10.1007/s12306-026-00962-9","DOIUrl":"https://doi.org/10.1007/s12306-026-00962-9","url":null,"abstract":"<p><p>Osgood-Schlatter disease (OSD), also known as tibial tubercle apophysitis, is a traction apophysitis of the tibial tuberosity that disproportionately affects adolescents during periods of rapid skeletal growth (1). First described independently by Robert Osgood and Carl Schlatter in 1903, this condition represents the most prevalent cause of knee pain in the skeletally immature athletic population (3). Despite its self-limiting nature, OSD can result in prolonged symptoms lasting up to 24 months, with approximately 10% of affected individuals experiencing persistent pain into adulthood, particularly with activities such as kneeling. However, conservative management achieves successful outcomes in over 90% of pediatric cases (4). The burden of OSD extends beyond immediate symptomatology. Recent epidemiological data indicate that lower extremity apophysitis can result in pain lasting between 1 and 45 weeks, with potential consequences for physical activity participation during critical developmental periods (7). This is particularly concerning given the established relationship between childhood physical activity and long-term health outcomes. Furthermore, the condition's propensity to affect athletes during peak competitive years raises important considerations for talent development, psychological well-being, and long-term athletic participation. Historically, OSD management has relied heavily on activity modification and symptomatic treatment. However, advances in our understanding of its pathophysiology-particularly the identification of specific biomechanical risk factors and critical developmental windows-have enabled a more nuanced, multidimensional approach to care.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}