• Osgood-Schlatter Disease

    (Osteochondrosis)

    Definition

    Osgood-Schlatter disease is inflammation of the bone and surrounding soft tissue just below the knee. It occurs at the point where the tibia (shinbone) attaches to the tendon of the kneecap (patellar tendon).
    The Knee
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    Causes

    Osgood-Schlatter disease is caused by repeated tension or stress on the upper part of the shinbone during its growth spurts.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition.
    • Sex: males are at greater risk than females
    • Age: 10 to 18 years old
    • Rapid growth spurts
    • Activities that stress the patellar tendon, such as jogging, jumping, and sudden turning
    • Being overweight

    Symptoms

    Symptoms include:
    • Pain, swelling, and/or tenderness just below the knee that usually worsens during physical activity
    • A swollen, painful bump just below the knee that is sensitive to touch

    Diagnosis

    The doctor will ask about your symptoms, medical history, and physical activity, and examine your knee. Diagnosis is based on the symptoms. In some cases, you may have an x-ray or an ultrasound of the knee.

    Treatment

    Osgood-Schlatter disease may go away once the bones and tendons have finished growing.
    Treatment may include:

    Limited Exercise

    • Avoid exercise that stresses the patellar tendon until the swelling and pain go away. This may be as short as 1 to 2 weeks, or as long as three months or more.
    • Once the swelling and pain subside, limit those same activities to help prevent recurrence.
    • Sometimes it may be possible to resume more vigorous exercise while wearing an elastic pressure bandage (such as Ace brand) or a knee brace.

    Pain Relief

      Apply ice to relieve swelling and pain:
      • During a flare-up
      • After exercise to prevent recurrence of flare-ups
    • Use one of the following drugs to help reduce inflammation and pain:
    • Ibuprofen (Motrin, Advil)
    • Naproxen (Aleve, Naprosyn)
    • Acetaminophen (Tylenol)
    • Aspirin
      • Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome. Ask your doctor which other medicines are safe for your child.
    • In severe cases, local injection of cortisone can reduce inflammation and pain.

    Surgery

    If the patellar tendon has pulled away from the shinbone, surgery may be needed to repair the tendon and remove fragments of bone. In most cases, surgery is not needed.

    Prevention

    To prevent the occurrence or recurrence of Osgood-Schlatter disease:
    • Encourage overweight children to lose weight.
    • Encourage susceptible children to exercise regularly but moderately, and to avoid weight-bearing activities that put excessive stress on the patellar tendon. These include jogging, jumping, and sudden turning.
    • Ask your child's doctor for stretching and strengthening exercises for the shinbone/patellar tendon.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org

    American Academy of Orthopaedic Surgeons http://www.aaos.org

    American Physical Therapy Association http://www.apta.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Physical Therapy Canada http://www.physicaltherapy.ca

    References

    American Academy of Family Physicians website. Available at: http://www.aafp.org. Accessed October 11, 2005.

    Aronen JG and Garrick JG. Sports-induced inflammation in the lower extremities. Hosp Pract. 1999;34:51.

    Beers MH. The Merck Manual of Medical Information. 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003.

    Ducher G, Cook J, Lammers G, Coombs P, Ptazsnik R, Black J, Bass SL. The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage. J Sci Med Sport. 2010;13(1):20-23.

    National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov. Accessed October 11, 2005.

    Pihlajamäki HK, Visuri TI. Long-term outcome after surgical treatment of unresolved osgood-schlatter disease in young men: surgical technique. J Bone Joint Surg Am. 2010;92: Suppl 1 Pt 2:258-264.

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