Advertisement - Hide this advert





Author Topic: Tibial tuberosity avulsion fracture, ununited ossicle in an adult (xray inside)  (Read 5446 times)

0 Members and 1 Guest are viewing this topic.

Offline IvanAndreevich

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
I am a 24 year old competitive volleyball player. I had undiagnosed OSD for ~10 years which wasn't that bad until last year or two. In hind sight, I am fairly sure I've had this fracture since 13. Icing and rest did the trick most of the time until I increased my training and competition load about 2 years ago.

First of all, here's the knee x-ray - http://img833.imageshack.us/img833/8843/kneeproblem.jpg I got to see it for the first time today, and I now know that I never had a chance to resolve the source of all my knee problems on my own.

I've taken the last 6 months off any hard training and have been working daily on flexibility and knee + hip stability exercises. I had a whole spectrum of knee problems (IT band syndrome, PFM syndrome, etc, etc) which are now much better. But obviously not this piece of crap.

Other than the screwing it to the tibia + cast for 4 weeks (this is very problematic for me) - is there any other way? It's very small, so perhaps it can just be removed cleanly for a quicker recovery? I am seeing my family doctor tomorrow, but I need to know what other options I have.

 :-\
« Last Edit: July 25, 2010, 10:14:42 PM by IvanAndreevich »

Offline IvanAndreevich

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Tibial tuberosity avulsion fracture (xray inside)
« Reply #1 on: July 21, 2010, 07:48:02 PM »
Well, I did find a very promising type of treatment outlined in an article here - http://www.ncbi.nlm.nih.gov/pubmed/18760218?dopt=AbstractPlus

Quote
Abstract

Surgical excision of the ossicles has been suggested for unresolved sequelae of Osgood-Schlatter disease in adults resistant to conservative measures. A 24-year-old, male semiprofessional soccer player had anterior knee pain during sports activity and climbing stairs that had been treated conservatively for 2 years. On physical examination, there was a permanent tibial tubercle with pain. On radiographic examination, an ununited ossicle was seen beneath the patellar tendon. Arthroscopy was performed through the standard low anterolateral and anteromedial portals close to the patellar tendon. Soft tissue at the retropatellar surface and the inflamed infrapatellar fat pad beneath the patellar tendon were debrided with a motorized shaver. Localization of the ununited ossicle was performed by use of an image intensifier. The ossicle was separated from the surrounding soft tissue with a motorized shaver and removed by use of a grasper. After excision of the ossicle, the inflamed surface of the retropatellar tendon was also debrided. The contouring of the irregular surface of the tibial tubercle was performed by use of a motorized bur. After 6 weeks, the patient returned to sports activities without any restrictions. This study showed that all of the described procedures might be done arthroscopically and sports activity may be allowed earlier.

I emailed the author and he said he performed about 40 of these with good results. Now, the real question is if I can get this done here in Canada because this reads like music to my ears!

Offline pattyb

  • Forum Faithful
  • ****
  • Posts: 158
  • Liked: 0
Re: Tibial tuberosity avulsion fracture (xray inside)
« Reply #2 on: July 22, 2010, 09:00:26 PM »
Best of luck to you, Ivan!
I'm wishing you are speedy and uneventful return to the court!

Patty
2010
5/21 Injured by dog-TPF Type III
5/27 Surgery 1 plate and 5 screws
5/30 Left hospital
7/1  First PT - 5 weeks
7/8  PWB - 6 weeks
7/29 FWB - 9 weeks
8/2  Back to work FT - 10 weeks
8/20 Told to ditch cane by PT -12 weeks
9/13 Released by PT - 15 weeks
10/18/2011 HW Removal

Offline IvanAndreevich

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Tibial tuberosity avulsion fracture (xray inside)
« Reply #3 on: July 25, 2010, 10:13:32 PM »
My family doc thinks it's an ununited ossicle rather than an old avulsion fracture. I don't know, but it doesn't really matter at this stage.

I will get an appointment with an orthopedic surgeon in September to discuss what they can do here. Would be swell if they could perform the procedure, as outlined by professor Beyzadeoglu from Istanbul.

Until then, I am going through a rigorous stretching, core and knee stabilization, and gluteus medius and vastus medialis (VMO) strengthening program which includes eccentric exercises for patellar tendinopathy which I surely have. Also bought some quality arch supports which my psyo recommended.















support