I have seen many patients with tibial tuberosity epiphysitis in the clinic recently. I will upload the disease condition. The disease is a common problem. Osteochondritis of the tibial tuberosity [Disease Overview] This disease, also known as Osgood-Schlatter disease, is common in young athletes, mostly in males, and can occur unilaterally or bilaterally. It is common in soccer, basketball, gymnastics and skills. The age of onset is 13 to 15 years with a history of strenuous exercise. The pain and mild swelling at the tibial tuberosity is aggravated by running, jumping and walking up and down stairs and is relieved by rest. On examination, the patient has swelling and tenderness at the tibial tuberosity and pain at the tibial tuberosity when the knee is extended and resisted. The symptoms decrease with age and disappear when the epiphysis is completely ossified and the patellar tendon becomes rigid. However, the tibial tuberosity remains elevated. Rarely, the pain remains after the developmental period. In the early stage of the disease, there are no obvious abnormalities on X-ray, and the soft tissue shadow is slightly larger. In the middle stage, changes in density, fracture or upward movement of the nucleus can be seen. In the late stage, calcification or ossification can be seen here. In the early stage, the duration and amount of exercise should be reduced and deep squats should be avoided until the pain is relieved. If the pain is chronic and tolerable, there is no need to stop training, but adjust the training content appropriately and reduce the bouncing training. Local anatomy】 The tibial tuberosity in adolescents is the lingual epiphysis, which is the stopping point of the patellar tendon. When the epiphysis is repeatedly and strongly strained, the disease is easily triggered. The mechanism of injury may be local strain causing hematoma, mechanization and calcification, or local strain causing ischemia at the tibial tuberosity stop of the patellar tendon. Both mechanisms of injury may coexist, resulting in increased tension in the tendon and causing pain. Calcification and ossification within the tendon cause the tibial tuberosity to bulge. Indications for surgery】 If long-term conservative treatment is ineffective, surgery can be used. The procedure is performed in the lumbar spinal canal anesthesia, supine position. 2, Incision along the medial edge of the patellar tendon or central longitudinal incision of the patellar tendon to expose the subpatellar tendon bursa and the stop. 3, Excise the bursa and local inflammatory tissues of the patellar tendon, thoroughly clean the local intra-tendon degenerative group and ossified tissue weave, and retain the stop if the strength of the patellar tendon stop is still good after cleaning. 4, If the local stop is weak, the lesioned tibial tuberosity is cut down with a bone knife, and the patellar tendon stop is reconstructed by cutting a bone groove at the appropriate height of the tibial tuberosity and pulling the braided patellar tendon into the bone groove. 5.Joint microscopy can also explore and deal with other tissue injuries in the joint. Post-operative rehabilitation】 If it is only a simple clean-up surgery, the strength of the patellar tendon stop is good, and you can start knee flexion exercises after the bleeding period (3 to 4 days), to the extent that the pain can be tolerated, and the knee flexion is basically normal 2 to 3 weeks after surgery, and you can resume sports after 2 to 3 months. In the case of patellar tendon stop reconstruction surgery, postoperative knee extension brace fixation and protection will take 6 to 8 weeks. The rehabilitation exercises that can be performed in the early postoperative period include: quadriceps isometric stretching exercises to reduce muscle atrophy, patellar pushing and active and passive knee flexion exercises from 0 to 30 degrees (this range of activity has little strain on the patellar tendon stop after suturing) to reduce intra-articular adhesions; anti-gravity straight leg raising should not be performed until at least 4 to 6 weeks postoperatively; gradually increase the knee flexion angle according to the intraoperative situation and the patient’s feeling. The angle of knee flexion is gradually increased according to the intraoperative condition and the patient’s feeling, aiming to reach 90 degrees at 6 to 8 weeks after surgery, and the angle is close to normal at 12 weeks after surgery. Exercise can be resumed six months after surgery.