Ahlbaeck disease
Ahlbaeck’s disease is the name for osteonecrosis of the medial femoral condyle. The part of the knee joint formed by the thigh is the affected structure here. It manifests itself through diffuse pain, which usually increases rapidly. This does not result in fragments of cartilage–bone splintering into the joint cavity as in osteochondrosis dissecans, but rather in a collapse of the bone structure. The joint surface is deformed and the knee is forced into a varus malposition (bowleg).
Ostenonecrosis in the knee in the child
The special feature of the child is that it is still growing. Above and below the knee there are the cartilaginous epiphyseal joints, from which new bone emerges and thus allows the bone to grow. The disadvantage of the growth zone is that the load-bearing capacity is not as great as that of a fully formed bone.
For this reason, overloading can occur more easily, especially when children do intensive competitive sports. As a result, correct ossification is no longer guaranteed and osteonecrosis can occur. Due to their growth potential, children have the advantage that osteonecroses can heal well by themselves if the affected knee joint is spared for a while.
Sinding-Larsen’s disease is an osteonecrosis that primarily affects boys of primary school age. The site of necrosis is at the lower end of the kneecap and hurts under stress. There is no detachment of the lower end of the patella.
In most cases, a break from sports is sufficient to allow the bone to heal independently. In some cases, a splint can be worn for support to immobilize the stretched knee. Osgood-Schlatter’s disease is an osteonecrosis of the tibial plateau that often affects young patients.
It is suspected that this disease pattern is caused by an imbalance between the load-bearing capacity of the cartilage during growth and excessive strain from sports. In some cases, small bone fragments detach from the cartilage, which are found in the area of the quadriceps tendon.Even in this case, conservative treatment with relief until complete immobilization with splint and crutches is sufficient. If small pieces of bone have become loose, they can be removed in a small surgical procedure after growth has stopped.
