Risk Factors for Osgood-Schlatter Disease
The primary risk factors for Osgood-Schlatter disease include regular participation in high-impact sports, muscle tightness (particularly rectus femoris shortening), and being in the adolescent growth spurt phase. 1, 2
Key Risk Factors
Age and Growth-Related Factors
- Occurs during bone growth phase in adolescents 1
- Peak age for boys: 12-15 years 1
- Peak age for girls: similar to boys in recent studies 1
- Coincides with the appearance of the secondary ossification center of the tibia 3
Physical Activity Factors
- Regular participation in sports activities (odds ratio 1.94; 95% CI 1.22-3.10) 2
- Sports with explosive components 3
- High-impact activities such as:
- Running
- Jumping
- Climbing stairs 4
Musculoskeletal Factors
- Rectus femoris muscle shortening (odds ratio 7.15; 95% CI 2.86-17.86) 2
- Muscle tightness, particularly in the quadriceps 1
- Hamstring muscle flexibility issues 1
- Muscle weakness during knee extension 1
Biomechanical Factors
- Altered biomechanical functions of the knee due to muscle shortening 1
- High forces generated on the insertion zone of the patellar tendon 3
Body Composition
- Body weight may be a contributing factor 1
Changing Demographics
- Historically more common in boys, but recent evidence suggests equal distribution between sexes
- Increased participation of young females in high-impact sports may explain this shift 1
Clinical Implications
The multifactorial nature of Osgood-Schlatter disease suggests that prevention strategies should focus on:
- Implementing quadriceps and hamstring stretching exercises in regular practice routines for children involved in sports 1
- Monitoring adolescents during growth spurts, particularly those engaged in high-impact sports
- Addressing muscle imbalances and tightness, especially in the rectus femoris muscle 2
- Creating prevention programs that can be objectively assessed, particularly for sports generating high forces on the patellar tendon insertion 3
Early identification of these risk factors can help implement preventive measures, as conservative management is successful in over 90% of patients 1. For those with persistent symptoms after physeal closure, surgical intervention may be necessary.