Osgood Schlatters disease
Osgood-Schlatters disease is an inflammation and partial avulsion of the tibial tubercle, a part of the tibia where the patella tendon is attached. It is named after Dr Robert Osgood and Dr Carl Schlatter, who first described the condition in 1903.
Who does it affect?
Osgood-Schlatters disease typically affects boys and girls in late childhood or early adolescence. It is most common between the ages of 11 and 15 years as the area where the patella tendon attaches is most vulnerable to traction and avulsion in this age group. Bones typically grow faster than muscles and tendons in adolescence and this can result in tightness making adolescents more vulnerable to Osgood-Schlatters disease. It is more common in boys. This is probably because boys usually do more sports and physical exercise which places higher demands on the attachment of the patella tendon to the tibial tubercle.
The condition is caused by excessive force acting on the tibial tubercle and is more common in athletes. A retrospective study of young athletes demonstrated that 21.2% of the athletes had suffered from Osgood-Schlatters disease as compared to 4.5% in the non athletic group. Sports that require lots of running, jumping, squatting and kneeling are particularly associated with Osgood-Schlatters disease. Sufferers are often involved in football, gymnastics or ballet.
Osgood-Schlatters disease typically causes pain or tenderness over the tibial tubercle a few centimetres below the patella (knee cap). It can cause swelling which may be visible. Pain often occurs during activities which involve running and jumping and can improve with rest although occasionally can be constant. The severity and duration of the pain can vary between individuals. There may be associated tightness of quadriceps or hamstring muscles. It typically affects one knee but can affect both.
Diagnosis of Osgood-Schlatters can usually be made following a history of the symptoms and clinical examination. Occasionally other investigations may be helpful such as xrays. An MRI scan is not usually necessary.
The most important treatment is rest and restriction of sporting activities. An exercise program and physiotherapy can be helpful. This includes isometric exercises where the joints don’t move and exercises to increase the flexibility of the quadriceps and hamstring muscles.
Symptoms may recur while the tibial tubercle is healing and the process can take 18 – 24 months to resolve. Knee supports to reduce the tension on the patella tendon can be helpful and anti-inflammatory medication (aspirin or ibuprofen) can help also help with the pain. Low impact exercise such as cycling may limit symptoms. The long term prognosis is good. It is a self limiting condition and eventually resolves.