Osgood-Schlatter Disease: the cause of your child’s knee pain.

Osgood-Schlatter Disease (OSD) is an overuse injury that results in pain at the front of the knee in active adolescent population.

Clinical Presentation

Children with OSD will complain of pain at the front of the knee (below the knee cap) during and after exercising, especially when they do a lot of jumping or sprinting.

The child will also complain of pain when they touch the the tibial tuberosity (the bit of bone that stick out of the leg bone under the knee).

Pathophysiology

OSD occurs when bone growth of the tibia exceeds the ability of the patellar tendon to stretch sufficiently. This leads to tension across the tibia tuberosity (A growth pate which provides point for muscles attachment).

Repetitive stress to the strong patellar tendon and the soft tuberosity of the tibia results in irritation.

OSD typically occurs during growth spurts, at 10-15 years olds for boys and 8-13 years olds for girls. The illness is most common in boys. OSD is a very “ normal” problem and is present in 9.8% of 12-15 year olds.

Treatment

The aim of the treatment is to reduce swelling & pain over the tuberosity.

A combination of pain relief (NSAIDs) and ice will often be useful.

Having the advice of a sports physio is very important.

A typical physio treatment for OSD will consist on:

• Stretching of quads, hamstring and calves.

• Strengthening of the hip and leg muscles (to avoid compensation)

• Review of the training load,

• Advice Knee pad to prevent direct impact

• Review of the level of activity until symptoms resolve,

• And help to maintain/return to full fitness.

Shockwave therapy has also been shown to help for patients with persistent pain.

Prognosis

Osgood-Schlatter has an excellent prognosis, but recovery is slow, it may take months to 2 years to resolve. Very rarely, pain may last longer than this.

Surgery is indicated in symptoms persisting for >1-2 years  after skeletal maturity.

Surgery had no benefit over conservative management and is more likely to cause complications.

Differential Diagnosis

Not all anterior knee pain are caused by OSD. Our physios will help you to get the right diagnosis by ruling out other conditions such as:

Fracture of tibial tuberosity

Hoffas disease – Fat pad impingement

Osteomyelitis – Pain activity & rest; signs of infection present

Patella tendinopathy

Chondromalacia – Pain on pressure of patella