Osgood-Schlatter's Disease

This condition is caused by traction on the tibial tubercle at the point of insertion of the patellar tendon. This traction causes microfractures. It occurs during late childhood and adolescence and is associated with repeated vigorous activity.

Knee pain is common in athletes.
The greatest risk factor is frequent sports in adolescent males. Osgood-Schlatter disease often is encountered in children 10 to 15 years of age who participate in sports such as football, basketball, gymnastics, and volleyball.¹

Symptoms

Pain and swelling below the knee.
20 to 30 percent of patients report bilateral symptoms.²

Signs

• Examination reveals tenderness and swelling at the tibial tubercle.
• Hip examination is important because some childhood hip conditions (e.g., slipped capital femoral epiphysis) can refer pain to the knee.

X-rays may reveal fragmentation and irregular ossification at the tibial tubercle, but are rarely indicated unless there is suspicion of other injuries.¹

• Osteochondritis dissecans
• Patellar or quadriceps tendonitis
• Patellofemoral pain syndrome
• Inferior patellar pole traction apophysitis (Sinding-Larsen disease)
• Patellar stress fracture
• Prepatellar or infrapatellar bursitis
• Referred pain

Non-Drug

• Most patients respond to conservative treatment consisting of rest from painful activities and application of ice.
• Quadriceps stretching as part of a strengthening program should be encouraged once symptoms are controlled.
• Immobilisation of the knee may be needed.

Drug

• Analgesic medications as needed for pain.
• Corticosteroid injection of the tibial tubercle is not recommended because of potential complications such as subcutaneous atrophy.^{1 2}

Surgical

There may be an ossicle under the distal patellar tendon as a consequence of the disease. Other complications are a prominent tibial tubercle or an uneven surface of anterior superior tibia. These may cause pain and disability from recurrent injuries or exercise. Surgical treatment gives good results in these unresolved cases.³

Osgood-Schlatter disease usually is self-limiting. However, some complications can occur, such as mild discomfort with kneeling, a residual bony deformity, and painful ossicles in the distal patellar tendon.⁴ Most patients are able to return to full activity within two to three weeks. The use of an infrapatellar strap for six to eight weeks may provide symptomatic relief during activity.²