Eponymous knee injuries

Eponymythology: The myths behind the history

Eponymythology associated with signs, symptoms, investigation and management of knee injuries. We review related eponyms, the person behind their origin, their relevance today, and modern terminology

Osgood-Schlatter disease (1903)

Osgood–Schlatter disease (OSD) is an osteochondrosis or traction apophysitis of the tibial tubercle. OSD is common during the early adolescent growth spurt between 10 and 15 years of age, particularly in children who participate in sports that involve running and jumping. It is more common in males and may affect both knees.

Osgood (1873–1956), wrote about bone changes on the tibial tubercle with a review of 10 patients in his time as a roetgenologist at Boston Children’s Hospital

It is possible, however, to have a partial separation of the tubercle and the interference with normal function be so slight that the condition is often unrecognized and the diagnosis made of a bursitis or a periostitis, or even a joint fringe (see fig 5, 6). The x-ray evidence of this is apparently indisputable and the clinical picture absolutely consistent with the true condition.

Osgood 1903

Schlatter published [Injuries of the beak-shaped appendage of the upper tibial epiphysis] including his observations of 7 patients with separation of the anterior rostrate (beak) process from the upper tibia noting. The condition was originally referred to as Schlatterschen Krankheit. He noted:

…these injuries represent a clinically sharply delineated profile of the disease whose symptom complex is in most cases simple and easy to diagnose without the use of radiographs

Schlatter 1903

• Robert Bayley Osgood (1873 – 1956) was an American orthopedic surgeon.
• Osgood RB. Lesions of the tibial tubercle occurring during adolescence. Boston Medical and Surgical Journal 1903; 148: 114-117
• Carl B. Schlatter (1864 – 1934) was a Swiss Surgeon.
• Schlatter C. Verletzungen des schnabelförmigen Forsatzes der oberen Tibiaepiphyse. Beitrage zur klinischen Chirurgie, 1903; 38: 874-87

Segond fracture (1879)

Segond fracture: Avulsion fracture (small) of the lateral surface of the lateral tibial condyle. Usually results from excessive internal rotation and varus stress resulting in increased tension on the lateral capsular ligament of the knee joint. In the majority of cases a segond avulsion fracture is associated with detachment of the capsular portion of the lateral collateral ligament and tears of the anterior cruciate ligament. Additional injury to menisci and other supporting ligaments.

It’s never Gerdy’s tubercle that gives way, but the portion of bone immediately behind it…the lesion is pathognomonic of torsion of the knee in internal rotation and slight flexion of the lower leg and is associated with rupture of the anterior cruciate ligament

Segond 1879

In 1879 Paul Segond, using cadaveric knees, demonstrated that excessive tibial internal rotation with the knee flexed produced an avulsion fracture of the lateral tibial condyle in 17 out of 38 knees. In 1936 Henry Milch first reported the avulsion fracture on radiographs of 3 acutely injured knees

• Paul Ferdinand Segond (1851 – 1912) was a French Orthopaedic Surgeon.
• Segond P. Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrès Médical 1879; 16: 297–299, 319–321, 340–341

Pellegrini-Stieda syndrome (1905/1908)

Köhler-Pellegrini-Stieda lesion: Ossification in or near the tibial collateral ligament (medial femoral collateral ligament) adjacent to the margin of the medial femoral condyle. Ossified post-traumatic lesion (presumed secondary to Stieda fracture)

On the inner condyle proximal a small flat dark shadow, just visible on the radiograph, which can only correspond with a connective tissue ossification.

Kohler 1905

X-ray examination of the affected area reveals a shadow of the perfectly normal distal end of the femur and proximal end of the tibia; the tumour produces a light shadow which is just perceptible at the base of the soft parts: it is located laterally to the MCL of the femur

Pellegrini 1905

…the position of the shadow in the X-ray fits more with a tear of the muscle insertion (upper portion of the internal epicondyle) than with a tear of the insertion of the inner sideband (lower portion of the internal epicondyle).

Stieda 1908

• Alban Köhler (1874 – 1947) was a German Radiologist.
• Köhler A. Die normale und pathologische Anatomie des Hüftgelenks und Oberschenkels in röntgenographischer Darstellung. Hamburg, Lucas Gräfe & Sillem, 1905
• Augusto Pellegrini (1877 – 1958) was an Italian Surgeon.
• Pellegrini A. Ossificazione traumatica del ligamento collaterale tibiale dell’articolazione del ginocchio sinistro. [Traumatic calcification of the collateral tibial ligament of the knee joint] Clinica moderna (Firenze) 1905; 11: 433-439
• Eugen Julius Karl Paul Alfred Stieda (1869 – 1945) was a German Surgeon.
• Stieda A. Uber eine typische verletzung am unteren femurende. Archiv für Klinische Chirurgie, 1908; 85: 815-826