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by Alan R

Osgood-Schlatter Disease

(Osteochondrosis)

Definition

Osgood-Schlatter disease is inflammation of the bone and surrounding soft tissue just below the knee. It occurs at the point where the shinbone attaches to the tendon of the kneecap.
The Knee
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Causes

Osgood-Schlatter disease is caused by repeated tension or stress on the upper part of the shinbone during its growth spurts.

Risk Factors

Factors that may increase your risk of getting this condition include:
  • Sex: males are at greater risk than females
  • Age: 10 to 18 years old
  • Rapid growth spurts
  • Activities that stress the patellar tendon, such as jogging, jumping, and sudden turning
  • Being overweight

Symptoms

Osgood-Schatter disease may cause:
  • Pain, swelling, and/or tenderness just below the knee that usually worsens during physical activity
  • A swollen, painful bump just below the knee

Diagnosis

The doctor will ask about your symptoms, medical history, and physical activity. An examination of your knee will be done. Diagnosis is based on the symptoms. In some cases, you may have an x-ray or an ultrasound of the knee.

Treatment

Osgood-Schlatter disease may go away when the bones and tendons have finished growing. The bump may be permanent.
Treatment may include:

Limited Exercise

  • Avoid exercise that stresses the patellar tendon until the swelling and pain go away. This may be as short as 1 to 2 weeks, or as long as three months or more.
  • Talk to your doctor about using a strap to stabilize the area during sports.
  • Use a brace or elastic bandage to support the area as it heals.
  • You may be referred to a physical therapist to strengthen the affected muscles.

Pain Relief

Pain and swelling may be relieved with:
  • Ice compresses during a flare-up or after exercise
  • An over-the-counter pain reliever, such as ibuprofen, naproxen, or acetaminophen
  • A local injection of cortisone in severe cases
Note : Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Surgery

If the patellar tendon has pulled away from the shinbone, surgery may be needed to repair the tendon and remove fragments of bone. In most cases, surgery is not needed.

Prevention

To prevent the occurrence or recurrence of Osgood-Schlatter disease:
  • Encourage overweight children to lose weight.
  • Encourage children to exercise regularly but moderately, and to avoid weight-bearing activities that put excessive stress on the patellar tendon. These include jogging, jumping, and sudden turning.
  • Ask your child's doctor for stretching and strengthening exercises for the shinbone/patellar tendon.

RESOURCES

FamilyDoctor.org - American Academy of Family Physicians http://familydoctor.org

OrthoInfo.org - American Academy of Orthopaedic Surgeons http://orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Atanda A, Shah S, O'Brien K. Osteochondrosis: common causes of pain in growing bones. Am Fam Physician. 2011 Feb 1;83(3):285-91.

Aronen JG and Garrick JG. Sports-induced inflammation in the lower extremities. Hosp Pract. 1999;34:51.

Ducher G, Cook J, Lammers G, Coombs P, Ptazsnik R, Black J, Bass SL. The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage. J Sci Med Sport. 2010;13(1):20-23.

Osgood-Schlatter disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 24, 2012. Accessed June 24, 2013.

Overuse injuries in children. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00613. Updated December 2012. Accessed June 24, 2013.

Pihlajamäki HK, Visuri TI. Long-term outcome after surgical treatment of unresolved Osgood-Schlatter disease in young men: surgical technique. J Bone Joint Surg A . 2010;92: Suppl 1 Pt 2:258-264.

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