Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with locally painful alterations around the tibial tuberosity apophysis. Up to 10% of adolescents are affected by OSD. Treatment is predominantly conservative. The aims of this systematic review are to comprehensively identify conservative treatment options for OSD, compare their effectiveness in selected outcomes, and describe potential research gaps. A systematic literature search was conducted using CENTRAL, CINAHL, EMBASE, MEDLINE, and PEDro databases. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were searched. We also systematically retrieved review articles for extraction of treatment recommendations. Of 767 identified studies, thirteen were included, comprising only two randomised controlled trials (RCTs). The included studies were published from 1948 to 2019 and included 747 patients with 937 affected knees. Study quality was poor to moderate. In addition to the studies, 15 review articles were included, among which the most prevalent treatment recommendations were compiled. Certain therapeutic approaches, such as stretching, have apparent efficacy, but no RCT comparing specific exercises with sham or usual-care treatment exists. Carefully controlled studies on well-described treatment approaches are needed to establish which conservative treatment options are most effective for patients with OSD.

Introduction: Brace treatment is the gold standard for patients with mild adolescent idiopathic scoliosis (Cobb angle 20°–40°). However, negative psychosocial impacts, physical constraints and incompliance cause many patients and parents to seek for so-called holistic and apparently less harmful approaches within the field of complementary and alternative medicine (CAM). Osteopathy—manual interventions on the viscera and locomotor system—is widely used for scoliosis. There is, however, a complete lack of evidence regarding its efficacy. We, therefore, tested the hypothesis that osteopathy alters trunk morphology, a prerequisite to unload the concave side of the scoliosis, and that it halts curve progression. Methods: This was a prospective, controlled trial of 20 post-pubertal young women (20°–40° idiopathic scoliosis) randomly allocated to an observation (group 0) or osteopathic treatment (group 1). The latter comprised three sessions (5 weeks). Trunk morphology (clinical examination, video rasterstereography) and spine flexibility (MediMouse^®) were assessed at a pre- and post-intervention with a 3-month interval (blinded examiner). We chose scoliometer measurement (rib hump, lumbar prominence) as the main outcome parameter. Results: Two patients in the treatment group refused further treatment and the final examination, as they felt no benefit after two osteopathic treatments. Regression analysis for repeat measurements (independent statistician) revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global spinal flexibility. Conclusions: We found no evidence to support osteopathy in the treatment of mild adolescent idiopathic scoliosis. Therefore, we caution against abandoning the conventional standard of care for mild idiopathic scoliosis. As for other CAM therapies, the use of osteopathy as a treatment option for scoliosis still needs to be clearly defined.

Purpose: The Knee Injury Osteoarthritis Outcome Score for children (KOOS‐Child) is a self‐administered, valid and reliable questionnaire for children and adolescents with knee disorders such as Osgood Schlatter disease, anterior knee pain, and patella dislocation. This study aimed to cross‐culturally adapt the German version of the KOOS‐Child questionnaire and test the reliability in two groups of children, one treated conservatively and the other surgically.Methods: A forward–backward translation of the original questionnaire into the German language was conducted. Children and adolescents between 10 and 18 years of age with knee disorders were included. Two groups were compared: sample one consisted of 24 participants with knee pain [20.8% boys; mean age = 13.4 (1.8) years treated conservatively. These participants completed the KOOS‐Child questionnaire twice within two weeks to assess test–retest reliability. The second sample included 23 subjects (21.7% boys; mean age = 15.3 (1.9) years] treated surgically due to a knee disorder. They completed the questionnaire before surgery and six months postoperatively. Test–retest reliability and internal consistency were assessed using Spearman’s rank correlation and Cronbach’s alpha.Results: All subscales showed a good to excellent internal consistency at both measurement points in both groups (conservatively treated group: a = 0.88–0.95; surgery group a = 0.80–0.91), with the exception of the subscale knee problems (conservatively treated: a = 0.60 and 0.52; surgery: α = 0.77 and 0.66). Test–retest reliability was between r = 0.85 and 0.94.Conclusion: The predominantly good to excellent internal consistency and the high test–retest reliability justifies the use of the German adaptation of the KOOS‐Child questionnaire as a reliable multidimensional instrument for measuring health status and therapeutic effects in adolescents’ knee disorders.

It remains controversial whether physical activity promotes bone health in childhood cancer survivors (CCS). We aimed to assess the effect of a one‐year general exercise intervention on lower body bone parameters of CCS. CCS ≥16 years at enrollment, −1. A nonstandardized personalized exercise programs might not be specific enough to promote bone health in CCS, although those compliant and those most in need may benefit. Future trials should include bone stimulating exercise programs targeting risk groups with reduced bone health and motivational features to maximize compliance.

Background: Idiopathic scoliosis is a three-dimensional spinal curvature treated during adolescence with physiotherapy, braces or surgery. This can be stressful for patients. Few studies compare the quality of life of adolescents with and without scoliosis. Our study aims to investigate the quality of life of adolescents with and without scoliosis using the KIDSCREEN-27 questionnaire. Objectives: The aim of this study was to investigate the quality of life of adolescents with scoliosis in comparison to adolescents without scoliosis. Method: This comparative cross-sectional study included 60 participants who answered KIDSCREEN-27 accompanied by questions about age, sport intensity and their school category. Girls between the ages of 12 and 17 were included in the study. For each category of KIDSCREEN-27, the values were compared between participants with and without scoliosis. Results: Statistical analysis was done using R Version 4.3.3. In none of the categories were the mean T-scores of adolescents with scoliosis significantly lower than those of the comparison group. In the scoliosis group, 33% (n = 10) showed values rated as ‘low’ quality of life in the category ‘physical well-being’. In the category ‘psychological well-being’, 36% (n = 11) showed ‘low’ values. Conclusion: A general statement about the quality of life in adolescents with scoliosis cannot be made, but monitoring during treatment appears to be important. It is a complex construct that varies for each patient. KIDSCREEN-27 can quickly and easily identify low quality of life in patients with scoliosis. Clinical implications: Physiotherapists play an important role in the scoliosis treatment team as they usually see the patients most often. Thus, early recognition of impaired quality of life is crucial to offer a targeted therapy plan.

Background: Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with painful osteochondrosis around the tibial tuberosity. Up to 10% of adolescents are affected by OSD. Treatment is primarily conservative or non-operative and includes injections, ice, braces, casts, tape and/or physiotherapy. However, treatment outcomes are often insufficiently described and there is lack of evidence for current best practice.Objective: The aims of this systematic review are to comprehensively identify conservative or non-operative treatment options for OSD, to compare their effectiveness in selected outcomes, and to describe potential research gaps. and to describe potential research gaps.Methods: This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. CENTRAL, CINAHL, EMBASE and MEDLINE via Ovid, and PEDro were searched through to January 6, 2020. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were retrieved. We included prospective, retrospective, case control, randomised, and non-randomised studies reporting on the effectiveness of any conservative or non-operative treatment of 6- to 28-year-old OSD patients. Studies written in English, German, or French were included. The quality of the included studies was assessed using the PEDro scale and extracted outcome data were narratively synthesized. In addition, we also systematically retrieved review articles for extraction of treatment recommendations.Results: Of 767 identified studies, thirteen were included: two randomised controlled trials (RCTs), two prospective and eight retrospective observational studies, and one case series. Eight studies had no control group. The included studies were published from 1948 to 2019 and included 747 patients (563 male, 119 female, 65 sex not reported) with 937 affected knees. The study quality was poor to moderate. The two included RCTs examined the effectiveness of surplus dextrose-injection in OSD patients treated with local anaesthetics injection and came to opposite conclusions. Other than that, inter-study heterogeneity prohibited any descriptive cumulative analyses. Among the 15 review articles, the most prevalent treatment recommendations were activity modification (15/15), quadriceps and hamstring stretching (13/15), medication (11/15), ice (11/15), strengthening of the quadriceps (9/15), and knee straps or brace (8/15).Conclusion: Conflicting evidence exists to support the use of dextrose injections. Certain therapeutic approaches, such as stretching, seem to work, but no RCT comparing specific exercises with sham or usual care treatment exists. Carefully controlled studies on well- described treatment approaches are needed to establish which conservative or non-operative treatment options are most effective for patients with OSD.