From the Research
Introduction to Osgood-Schlatter Disease
Osgood-Schlatter disease, also known as tibial tubercle apophysitis, is a common cause of anterior knee pain in children and adolescents, resulting from a traction apophysitis of the tibial tubercle 1. It is a self-limiting condition that typically resolves with skeletal maturity.
Causes and Risk Factors
The causes of Osgood-Schlatter disease include repetitive knee extensor mechanism contraction, which leads to inflammation of the patellar tendon at the tibial tuberosity 2. Risk factors for the disease include:
- Body weight
- Muscle tightness
- Muscle weakness during knee extension
- Flexibility of hamstring muscles
- Shortening of the rectus femoris, which can alter biomechanical functions of the knee 1
Preventive Measures
Prevention strategies for Osgood-Schlatter disease include:
- Quadriceps and hamstring stretching, which should be implemented in everyday practice routines for children who participate in regular sports activities 1
Signs and Symptoms
The signs and symptoms of Osgood-Schlatter disease include:
- Pain localized to the anterior aspect of the proximal tibia over the tibial tuberosity
- A dull ache exacerbated by jumping or stair climbing
- A bony prominence over the tibial tuberosity
- Soft tissue swelling and blurred margins of the patellar tendon in radiographs during the acute stage 3
Treatment
The treatment of Osgood-Schlatter disease is usually symptomatic and conservative, with the primary goal of reducing pain and swelling over the tibial tuberosity 3. Treatment options include:
- Limiting physical activities until symptoms are resolved
- Restricting physical activities for several months in some cases
- Autologous-conditioned plasma therapy, which has been used to treat treatment-resistant or refractory cases 4
- Surgical treatment, including open, bursoscopic, and arthroscopic techniques, which may be necessary for adults with continued symptoms who fail to respond to conservative treatment 2
Surgical Treatment
Surgical procedures for Osgood-Schlatter disease include:
- Open technique
- Bursoscopic technique
- Arthroscopic technique, which is beneficial due to early postoperative recovery, no incisional scar, and the ability to address concomitant intra-articular pathology 2
Caveats
It is essential to note that Osgood-Schlatter disease is a self-limiting condition, and most cases resolve spontaneously with skeletal maturity. However, some patients may experience continued symptoms and require further treatment. Additionally, the presence of pain with kneeling due to an ossicle that does not respond to conservative measures is an indication for surgery 3.