Foot Focus Podiatry

Mon - Fri : 08:30 - 5:30   |   reception@footfocuspodiatry.com.au
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Knee pain / Osgood Schlatter’s

 

Osgood-Schlatter’s disease (tibial tubercle apophysitis) is a form of knee pain found in growing children. The pain normally occurs at the tibial tubercle which is a bump of bone in the front of the knee.  The pain from Osgood-Schlatter’s comes from a pulling of the patellar tendon on the tibial tubercle and the growth plate underneath.

This condition most often occurs during growth spurts when bones, muscles, tendons, and other structures are growing. Children who participate in running and jumping sports are at an increased risk for this condition. However, less active adolescents may also experience this problem.

Podiatry treatment for Osgood-Schlatter’s disease:

It is always good to consult with one of our experienced podiatrists for treatment of any knee pain or Osgood-Schlatter’s pain.  Podiatry treatment for knee pain would include:

  • modifications of specific exercise routines to decrease the load on the knee
  • assessment of footwear
  • specific stretching and strength exercises
  • prescription orthotics (shoe inserts) following a full biomechanical assessment (e.g.joint range of motions, muscle strength and gait assessment).  Your orthotics would take into consideration your daily routine and sports your partake in.

Surgery is often not needed for Osgood Schlatter’s Disease. This is because the cartilage growth plate eventually stops its growth and fills in with bone when the child stops growing. The bone is stronger than cartilage and less prone to irritation. The pain and swelling go away because there is no new growth plate to be injured. Pain linked to Osgood-Schlatter disease almost always ends when an adolescent stops growing.

  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.

Matrixectomy with phenolization- This procedure involves removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol. This will cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence. This procedure is successful 95% of the time. The procedure takes about 10-15 minutes and can be performed in our rooms using local anaesthesia with or without sedation. Post operatively you will be required to soak your toe and apply a daily dressing. Wearing open toe shoes for at least 3-4 days is recommended. You maybe required to take oral antibiotics. Most patients do not require pain medication following the procedure, and if needed Panadol is sufficient for pain management. You can go back to regular shoes after one week.  This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a partial nail matrixectomy with phenolisation then please click here.