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Osgood-Schlatter Disease - Causes, Symptoms, Diagnosis, Treatment and Prevention

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Osgood-Schlatter disease is the condition of having a painful bulge below the knee joint. Read the below article to understand the condition further.

Written by

Dr. Deepiha. D

Medically reviewed by

Dr. Keerthi

Published At May 23, 2022
Reviewed AtFebruary 28, 2024

Introduction:

Osgood-Schlatter disease is a common condition affecting the knee joint, characterized by knee pain. The condition was named after two physicians, Dr. Robert Osgood and Dr. Carl Schlatter. They were the ones who described the disease in 1903. Osgood-Schlatter disease is the most common cause of knee pain in children and young adults. The condition mainly occurs during the rapid growth phase combined with high sporting or physical activity. It is more common in boys between 10 to 15 years of age. The condition is called rugby knee or football knee since it is prevalent among rugby or football players.

What Is Osgood-Schlatter Disease?

The knee is one of the largest and most complex joints in the body and acts as a hinge for the movement of the legs. The four bones, the femur (thigh bone), tibia (shin bone), fibula (calf bone), and patella (kneecap), along with the extensive network of ligaments and muscles, constitute the knee joint. The knee cap is attached to the shin bone by a patellar ligament.

Osgood-Schlatter disease is an inflammation of the patellar ligament at the spot where the ligament is connected to the shinbone. As a result, a bump appears below the knee joint, which causes pain, especially with activity.

What Are the Causes of Osgood-Schlatter Disease?

  • Osgood-Schlatter disease is caused by repetitive stress or injury applied to the knee joint. During the growth phase, new bones often form at the end of the existing bone. These active areas are called the growth plate of the bone. The growth plate is cartilage that transforms into bone once the growth phase is over. Hence, in adolescent age, overuse of the knee joint during sports involves pulling traction from the ligament to the growth plate, which cannot withstand the stress and causes swelling and pain.

  • Previous injury or trauma may be considered a risk factor predisposing to Osgood-Schlatter disease.

  • Falling in the knee bend position may cause a sudden involuntary strain on the ligament.

  • This condition runs in families.

  • Some research also suggests that children with ADHD (attention deficit hyperactivity disorder) are at risk of developing Osgood-Schlatter disease.

What Are the Symptoms of Osgood-Schlatter Disease?

Osgood-Schlatter disease is nothing but inflammation. The typical features of inflammation are pain, tenderness, swelling, redness, and heat. Other symptoms are joint stiffness, tight muscles, and difficulty in walking. Tightness may be felt in the thigh and hip region also. The pain may get aggravated during activity and alleviated while resting.

How to Diagnose Osgood-Schlatter Disease?

  • History Evaluation: Patient should explain their symptoms, which helps the physician understand how to proceed with the treatment.

  • Physical Examination: The area around the knee is examined and palpated (touch and feel with hands) to check for swelling and tenderness. The patient may be asked to walk, run, or climb stairs to see if the pain increases.

  • X-ray: Thickening of the ligament and soft tissue swelling can be demonstrated in X-rays, and they also help to rule out other conditions associated with knee pain.

  • Ultrasonography: The early stage of Osgood-Schaller disease can be identified in ultrasound since it can detect even a mild increase in swelling and new bone growth.

  • MRI (Magnetic Resonance Imaging): It is a highly sensitive technique to evaluate the soft tissue changes and patellar ligament abnormalities associated with Osgood-Schlatter disease.

How to Treat Osgood-Schlatter Disease?

The treatment for Osgood-Schlatter's disease aims to reduce swelling and pain. Generally, a conservative treatment protocol is recommended. They include,

  • Rest: Resting without activity relaxes the ligament, releases the stress from the growth plate, and allows it to heal.

  • Medication: Painkillers and anti-inflammatory drugs (NSAIDs - non-steroidal anti-inflammatory drugs) are prescribed based on the symptoms.

  • Physical Therapy: A physiotherapist will perform stretches and manipulation in the knee joint to relieve the strain.

  • Exercises: Stretching and muscle-strengthening exercises are recommended to reduce pain and prevent the disease from recurring.

  • Ice Pack: Placing cold packs on the inflamed area reduces swelling and pain.

  • Heat Fomentation: Applying heat promotes blood flow and reduces muscle stiffness.

  • Supporting Devices: An orthopedic brace (a unique medically designed holding device) or an orthopedic cast (a shell made up of plaster of Paris or fiberglass for stabilization) can reinforce immobilization for a quicker recovery.

  • Steroid Injection: If the symptoms are severe, cortisone shots may be given to reduce swelling and pain.

  • Surgery: Osgood-Schlatter disease rarely requires surgery. It may be the last resort recommended to remove any bony fragments irritating the ligament. The surgery is typically done only in adults after the growth phase.

Can Kids With Osgood-Schlatter Disease Do Sports?

Children with Osgood-Schlatter disease can continue participating in sports but need modifications to manage the symptoms.

  • Encourage participation in low-impact exercises.

  • Proper warm-up and stretching improve flexibility.

  • Limit high-impact activities.

  • Consider using knee pads and braces.

  • Allow adequate time for rest and recovery.

  • Monitor symptoms like changes in pain levels during physical activity.

How to Prevent Osgood-Schlatter Disease?

Children and young adults who are very active in sports are the ones at risk of developing Osgood-Schlatter disease.

Some of the general advice to prevent Osgood-Schlatter disease while playing sports is:

  • Wear shock-absorbing insoles in shoes to prevent injuries.

  • Apply heat 15 minutes before the sport to increase muscle flexibility.

  • Place an ice pack 15 minutes after sport to reduce muscle spasms.

  • Wear a protective kneecap or knee guard to protect the knee from the risk of further damage.

  • Regular stretching and strengthening exercises increase the muscles' flexibility, durability, and balance.

Conclusion:

Osgood-Schlatter disease is a periodic condition that does not last for a long time. The condition is self-limiting. Most of the symptoms will completely disappear after puberty. However, the bulge under the knee joint may persist forever without any pain. Children and teenagers can become depressed over Osgood-Schlatter disease during sports activities. Therefore, proper awareness and reassurance should be given to children and their parents regarding the condition, as it is only a temporary disability.

Frequently Asked Questions

1.

Does Osgood-Schlatter go away on its own?

Yes. Osgood-Schlatter disease is a left-limiting condition. It is typically inflammation of the bone growth plates during the active phase of growth in adolescents. Once the growth phase is complete, the condition will resolve, and they do not recur.

2.

Can Osgood-Schlatter cause permanent damage?

In most cases, the Osgood-Schlatter does not cause any permanent damage. The treatment is only symptomatic and conservative to reduce the swelling and pain. However, In a few cases, the bump below the knee region may persist forever but does not show any symptoms of pain or irritation.

3.

How serious is Osgood-Schlatter?

Physically, the Osgood-Schlatter disease is usually not that serious. But, the pain in kids and teens during physical and sporting activity may cause mental unhappiness and stagnate them. Hence, the condition should be addressed with proper care and reassurance. Preventive strategies like using supportive or protective sports equipment will help.

4.

Can Osgood-Schlatter cause problems later in life?

Once the cartilage in the growth plates is transformed o bone, the symptoms of Osgood-Schlatter disease will go away on its own and most probably they do not cause problems in adulthood. However during transformation, if any bony fragment is left out it may cause pain and irritation forever.

5.

What happens if you do not treat Osgood-Schlatter?

The treatment of Osgood-Schlatter disease involves simple conservative methods of rest for healing, icing to reduce swelling and pain, and physical therapy to increase the strength of the structures and prevent their recurrence. Even if the condition is not treated it resolves once the child grows up.

6.

How does Osgood-Schlatter go away?

During the active growth phase in teen kids, the long bones in the body often lengthen by adding new bones to their ends. These areas are called growth plates. The swelling and the pain of the knee in Osgood-Schlatter disease occur when the tibial apophysis (site of attachment of ligaments in the shin bone) is stressed during the growth phase

7.

Does Osgood-Schlatter show up on the x-ray?

Usually, a patient's history and physical examination are more sufficient to diagnose Osgood-Schlatter disease. X-rays may be necessary to confirm the diagnosis and to rule out any other causes of knee pain. Tendon changes and bone fragmentation may be visible in the X-rays.

8.

Is Osgood-Schlatter genetic?

Osgood-Schlatter disease comes under the category of osteochondrosis (a group of disorders affecting the growing skeleton). The exact origin of the disease is unknown but there are no studies to support the genetic predisposition of Osgood-Schlatter disease.

9.

How long does it take to recover from Osgood-Schlatter surgery?

The surgery for Osgood-Schlater disease is planned in adulthood only if the pain still persists. The pain may be due to the irritation of any left-out bony fragments in the knee region and surgery opts to remove them. Typically, the healing completes in six to eight weeks, but regaining fitness can take up to 12 months.

10.

Should you wear a brace for Osgood-Schlatter?

Yes, wearing knee braces will relieve the pressure on the patellar (knee cap) tendon. It helps by reducing the load on the knee during stretching and bending of the leg. Thus, you can be pain-free while playing sports or doing any physical activities. Specially designed knee braces are available with pads and straps.

11.

What is the fastest way to cure Osgood Schlatters?

Over-the-counter painkillers and anti-inflammatories will give immediate relief from pain and swelling. Rest until the healing phase is over. Later wearing supporting devices, alternate ice, and hot fomentation during between sports activity, practicing mild stretches, and muscle-strengthening exercises will help prevent the occurrence of symptoms

12.

How is Osgood-Schlatter treated in adults?

The symptoms of Osgood-Schlatter disease will persist in adulthood only for 10 % of patients. In such a refractory situation, the same conservative treatments are followed. Sometimes it may be necessary to opt for surgery to remove the retained bone fragments or to exercise the overlying bursa for decompression.

13.

How Is Osgood-Schlatter Treated?

The treatment of Osgood-Schlatter disease aims to reduce swelling and pain. The conservative treatment plan includes the following: 
- Resting without activity reduces stress and allows healing.
- Painkillers and anti-inflammatory drugs reduce pain and swelling.
- Physical therapy includes stretches and knee joint manipulation.
- Stretching and strengthening exercises to prevent a recurrence.
- Ice packs and hot fomentation as needed to relieve pain, swelling, and muscle stiffness.
- Orthopedic brace or cast as a supportive device. 
- Surgery is the last resort when the bony fragments cause ligament irritation. 

14.

What Are the Risk Factors of Osgood-Schlatter?

Children and young adults who are active and engage in sports activities are often affected. It is common, especially in rugby and football players. Individuals with previous trauma or injury are also prone to get this disease. According to little research, children with ADHD (attention deficit hyperactivity disorder) are also at risk of acquiring this disease. 

15.

When Does Osgood-Schlatter Go Away?

Usually, Osgood-Schlatter goes away on its own when the bone stops growth at around 14 to 18 years of age in teenagers. After proper healing, the individual can regain function. The healing phase usually takes six to eight weeks, but full recovery to play sports can take up to 12 weeks. 

16.

Is Osgood-Schlatter a Genetic Disease?

Osgood-Schlater disease is also called osteochondrosis and does not run in families, and there is no specific cause for acquiring this disease. This disease occurs during the growth spurt. It is more common in teenage boys compared to girls.

17.

Which Vitamins Help Osgood-Schlatter?

A combination of Vitamin D and selenium as supplements can allow healing. Some doctors recommend using a combination of manganese, zinc, and vitamin B6 for people affected by this disease. Vitamin D helps in improving bone health. 

18.

Can People With Osgood-Schlatter Play Sports?

The Osgood-Schlatter disease is a disease that does not last forever and is usually self-limiting. It is not considered a permanent disability. Children and adults affected with this disease must limit activity and refrain from playing until complete healing. Knee joints should not be flexed or extended; hence, exercises like lunges, squats, and other knee exercises should be avoided. 

19.

What Happens if Osgood Is Left Untreated?

The Osgood-Schlatter disease goes away once the growth spurt stops and during the fusion of the shin bone to the tibial tubercle. In individuals affected with this disease, symptoms like pain, tenderness, swelling, redness, tightness in the muscle, and walking difficulty are seen. If left untreated, it does not cause long-term complications. However, untreated children may complain of persistent pain and swelling. 

20.

Can Osgood-Schlatter Mean a Broken Bone?

The Osgood-Schlatter disease affects the knee joint, causing pain over the tibial tubercle due to growth plate swelling and irritation at the top of the shinbone. It is not malignant, and complications rarely occur. Sometimes, avulsion fractures can occur as a rare complication of this disease. 

21.

Can Osgood Stunt Growth?

The Osgood-Schlatter disease affects young children in their growth phase. This disease continues to cause painful symptoms until resolved or until bone saturation. However, it does not affect the children's growth or cause stunted growth.
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Dr. Keerthi

Dr. Keerthi

Orthopedician and Traumatology

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