What causes tibial tuberosity epiphysitis?

The main reason is that there are certain problems with the bones, in fact, it is also because of frequent exertion or strain, not getting a good ** or often maintaining a movement, so it will lead to such a problem.

It may be caused by excessive running exercise, it may also be caused by cold and fatigue, or it may be caused by other **, in this case, you should go to the hospital in time.

Chronic injuries to the body, or minor trauma over a long period of time, can lead to this disease.

Tibial tuberosity epiphysitis, also known as tibial tuberosity osteochondrosis (inflammation), aseptic necrosis of the tibial tuberosity, or O's-Shi disease. It is more common in male adolescents who exercise heavily and can occur unilaterally or bilaterally. Traditional Chinese medicine believes that this disease is related to knee strain, blood stasis blockage, cold and damp invasion, and paralysis of meridians, and belongs to the category of bone and joint "paralysis syndrome".

The tibia is located on the medial side of the lower leg and develops from four ossification centers, one at the diaphysis, one at the lower end, and two at the upper end of the tibia. The ossification center of the tibial bony process appears at about 11 years of age, and by the age of 17 the upper two ossification centers unite to form the tibial tuberosity, which is attached by the patellar ligament and is part of the knee extension device. Due to frequent strenuous exercise, such as jumping, running, playing football, etc., the tibial tuberosity is overstretched by the patellar ligament, and repeated traction injuries will cause partial avulsion of the tubercle, blocking or reducing the blood from the patellar ligament**, resulting in epiphyseal ischemia and necrosis of the bony process.

In the later stage, due to the increased activity of osteoblasts, bone hyperplasia occurs locally, and the tibial tuberosity is significantly hypertrophied, which is also the reason for the elevation of the upper end of the left calf. In recent years, it has also been suggested that the disease is caused by soft tissue injury to the patellar tendon caused by trauma, which causes tendonitis or tenosynovitis, and later heterotopic ossification occurs on the inflamed tendon, making the nodule thicker and bulging. Some scholars believe that the disease is caused by rapid epiphyseal growth.

Some adolescents will complain of knee pain, especially when squatting and going downstairs, and doctors often diagnose tibial tuberosity epiphysis after the visit. It occurs in adolescents who have not healed the epiphysis of the tibial tuberosity and are active in adolescents.

The tibial tuberosity is the anterior and lower part of the knee and is an important point of force to which the quadriceps muscles attach. The tibial tuberosity epiphysis fuses around the age of 19, and if there is trauma or long-term strenuous activities such as excessive running and jumping before the fusion, the quadriceps muscle will be over-drawn in this area, resulting in damage to the tibial tuberosity, and in severe cases, avulsion. The main clinical manifestations are swelling, tenderness, claudication, walking up and down stairs, and obvious pain when the knee is frequently flexed and extended.

Most of them are bilateral, the course of the disease progresses slowly, and there is a history of trauma before the onset of the disease. On examination, the tibial tuberosity is enlarged, local soft-tissue swelling, and pain is exacerbated by resistance to straightening the calf or passive flexion of the knee. X-rays show that the tongue-like protrusion of the tibial tubercle is dense with bone, and the epiphysis is irregular and even split into several pieces. Support.

Tibial tuberosity epiphysitis, also known as tibial tuberosity osteochondrosis, is characterized by a significant bulge below the knee joint and a feeling of soreness. Every time I climb the stairs or stairs, the pain gets worse and I have a limp. Because this disease is called osteoplasty, with the word "inflammation", some people may be confused with diseases caused by bacterial infections such as osteomyelitis.

In fact, the disease is not caused by a bacterial infection.

At both ends of the long bones of a newborn baby, many of the small bones are cartilage tissue. These cartilages are the base for the growth of bones. As they age, they slowly grow and ossify, making them taller.

The powerful quadriceps muscles in the front of the thigh are attached to the tibial tuberosity that protrudes below the knee through the patellar ligament. The quadriceps muscles contract, moving the calves and straightening the knees. Tibial tuberosities are also cartilage (also known as epiphysis) at birth, and begin to ossify around the age of 11 and are connected to the lower leg bone with a relatively weak cartilage.

During this period, if the activity of the teenager exceeds a certain limit, the quadriceps muscle is repeatedly stretched or injured locally through the patellar ligament, and the bone protrusion of the tibial tuberosity can be partially avulsed, causing insufficient blood, which in turn causes bone hyperplasia and mild swelling, and the nearby soft tissues will also be affected.

Because the disease is mainly related to activity and injury, it is more common in active middle school students around the age of 11 and 15, and there are more boys than girls, so it is a common disease. But this disease is not terrible and can be cured without treatment. Although the development of bones throughout the body does not stop completely until the age of 25, by the age of 16, this ossification center is fused with the tibia and the development is complete.

At this point, the epiphysis is no longer present and the epiphysis symptoms disappear naturally. If the symptoms are mild, just stop strenuous exercise and rest for a while. In severe cases, in addition to stopping strenuous activity, doctors may be prescribed topical hydroprednisone and procaine.

If the effect is not good, it can be done 3 or 4 times in a row, with an interval of 7 to 10 days each time, in case of ***. **There are generally no sequelae after the posterior, and a very small number of patients are left with knee reflexion deformity or unsightly knee shape, which can be corrected at the appropriate time.

In short, if you have tibial tuberosity epiphysitis, although you will have a limp due to pain, teenagers do not need to worry about sports. As long as you pay attention to exercise science, step by step, do not exceed physiological intensity, prevent injury, find discomfort, and consult a doctor in time, it will not cause adverse consequences.

**Measure. Most patients can reduce activity for 2-3 weeks. Severe symptoms require immobilization with a cast in the extended position for 4 to 6 weeks, followed by physiotherapy to restore knee extension and flexion.

However, it should take at least 4 months to resume strenuous knee activity. Hydrocortisone acetate can also be used for local sealing, but some people oppose it because it can cause atrophy of surrounding soft tissues and even spontaneous rupture of the patellar tendon.

If there is recurrent pain and knee dysfunction, and if you are older, surgery should be used. The patellar tendon can be split, the cortex on both sides of the tibial tuberosity can be turned over in the midline with a thin bone knife, and the debris can be scraped clean with a sharp curette. The cortex is then sutured in place, which relieves the pain and reduces the overly prominent tibial tuberosity to its normal shape.

7** Principle.

1.Non-surgical**: Restriction of activity. Stop running, jumping, kicking and other sports, and try to walk as little as possible or avoid knee extension and flexion activities. If the pain is severe, the lower limb long leg plaster can be fixed for 6 to 8 weeks.

2.Surgery**: In adulthood, patients with long-term local pain, mainly because the small epiphysis is not fused with the nodule, the non-fused epiphysis can be surgically removed; If there is obvious deformity, it can also be surgically removed.

8. Principles of medication.

1.Generally, no drugs are required**, only symptomatic**, such as rest, restriction of activities, external fixation of plaster, etc.

2.Patients with long-term local pain in adulthood can be surgically treated**, and antibiotics and support are required after surgery**.

Tibial tuberosity epiphysitis: the tibial tuberosity epiphysis is the insertion point of the patellar ligament and is a traction epiphysis. Due to the repetitive and intense contraction of the quadriceps muscle, the slow-moving injury inflammation of the epiphysis in the area is caused, resulting in avascular necrosis.

It is more common in patients with bilateral disease, and there are not many patients with bilateral disease. It is common in 10---15-year-old teenagers who love sports, and after the age of 20, the symptoms disappear because the ossification of the tibial tuberosity epiphysis fuses with the tibial tuberosity.

In case of pain, it can be applied externally with Osteosan**.

The pain of this disease can persist for a long time, and the symptoms can only disappear after ossification of the epiphysis, so it should be explained to the patient and his family to eliminate concerns and pay attention to prevention.

Analysis: Hello, your condition is tibial tuberosity epiphysitis, which is a disease that children are more prone to, and it is generally related to the traction of muscles with more exercise.

Advice: For this disease, generally with age, when the epiphysis is closed in adulthood, it will get better! Now, if the pain is obvious, you can rub some ointment, such as voltarin ointment or capsaicin ointment, etc.; To do a hot compress**, you can use a hot towel or hot water bottle for external application, and surgery is generally not required**.