Hyperosmolar dextrose injection for recalcitrant Osgood-Schlatter disease

Area of Science:

• Orthopedics
• Sports Medicine
• Regenerative Medicine

Background:

• Osgood-Schlatter disease is a common overuse injury in adolescent athletes, causing pain and limiting sport participation.
• Current treatments often focus on symptom management and may not fully restore function.

Purpose of the Study:

• To compare the efficacy of dextrose injection, lidocaine injection, and supervised usual care in reducing sport alteration and symptoms in adolescent athletes with Osgood-Schlatter disease.

Main Methods:

• Adolescent athletes were randomized to receive monthly injections of dextrose with or without lidocaine, or supervised usual care for 3 months.
• Treatment goals included achieving unaltered sport (Nirschl Pain Phase Scale < 4) and asymptomatic sport (Nirschl Pain Phase Scale = 0).

Main Results:

• Dextrose injections led to significantly more unaltered sport at 3 months compared to usual care (P = .001).
• Asymptomatic sport was more frequent with dextrose treatment than with lidocaine (P = .006) or usual care (P < .001) at 3 months.
• At 1 year, dextrose treatment resulted in more asymptomatic sport than lidocaine (P = .024) or usual care (P < .0001).

Conclusions:

• Injection therapy, particularly with dextrose, demonstrates superior efficacy in symptom reduction for Osgood-Schlatter disease compared to usual care.
• Dextrose injections were safe, well-tolerated, and facilitated quicker and more frequent return to unaltered and asymptomatic sport.