Osgood-Schlatter Disease

Medically Reviewed on 4/8/2024

What is Osgood-Schlatter disease?

Osgood-Schlatter Disease
Osgood-Schlatter disease causes knee swelling and inflammation.

Osgood-Schlatter disease is an overuse injury that causes inflammation of the tibial tubercle, the area on the tibia (shin bone), just below the knee, where the patellar tendon attaches.

The quadriceps, the large muscle on the front of the thigh, is responsible for extending (straightening) the knee. Its tendon is renamed the patellar tendon at the kneecap and attaches at the tibial tubercle. One can feel the tibial tubercle as a bony prominence on the front of the shin just below the kneecap. When the knee flexes, the tendon and its attachment is put under tension and strain. When the knee extends the muscle shortens and the stress on the tibial tubercle decreases.

Most common in adolescents who have undergone a growth spurt, Osgood-Schlatter disease tends to affect those who are involved in running, kneeling or jumping, or any activities that stretch the quadricep muscle and put strain on the tibia attachment point.

What are the causes and risk factors for Osgood-Schlatter disease?

The stress on the tibial tubercle, where the patellar tendon attaches, causes inflammation in that area. Pain occurs when the quadricep muscle is stretched as the knee flexes.

Most often, the disease occurs in adolescents between the ages of 10 and 14, who have undergone a rapid growth spurt. That rapid growth stretches the quadriceps muscles and puts a strain on the tibial tubercle where it attaches to the shin bone.

It is seen in adolescents who are involved in running and jumping, and those activities make the pain worse.

It can affect one or both knees.

What are symptoms of Osgood-Schlatter disease?

There is chronic inflammation at the tibial tubercle that causes symptoms of inflammation and pain.

The pain is located in the front of the knee and comes on gradually. The pain increases with running, jumping and squatting, all activities that stress the knee especially when it is forced to flex. Walking uphill or climbing steps will make the pain worse.

The knee pain gets better with rest.

How bad can Osgood-Schlatter disease get (severity)?

Osgood-Schlatter disease will eventually resolve over time, but the pain may be severe enough to limit activity and affect quality of life. Symptoms may be severe enough to prevent participating in sporting events.

Diagnosis of Osgood-Schlatter disease

The diagnosis of Osgood-Schlatter disease is made using patient history and physical exam.

This is a disease of adolescence and by definition is found in children whose skeletons have not fully matured. It is often seen in those who have had a significant growth spurt stretching the muscles and tendons in the body.

Often, the quadricep muscles in the front of the thigh, and the hamstrings in the back of the thigh, are tight and not very flexible.

The knee exam will find that the tibial tubercle is tender to touch and may be more prominent because of the chronic inflammation caused by the patellar tendon pulling on its attachment.

While the tubercle may be more noticeable, it is not necessarily red or warm to the touch.

X-rays are not needed to make the diagnosis of Osgood-Schlatter disease. However, they may be needed if the health care provider is concerned that there may be another cause of knee pain. Potential concerning findings that may require an X-ray or other tests include the following:

  • pain that has an acute rather than gradual onset
  • pain that occurs immediately after trauma
  • pain that does not resolve with rest
  • pain at night
  • physical exam that finds knee redness and warmth

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What is the treatment for Osgood-Schlatter disease?

How do you treat Osgood-Schlatter disease?

Osgood-Schlatter disease is self-limiting, which means it usually resolves on its own, but may take 6-18 months to get better.

Treatment is aimed at symptom control by decreasing inflammation. The use of over-the-counter pain medication like ibuprofen and acetaminophen may be helpful. A short course of ibuprofen (3-4 days) may be helpful with an acute flare.

Physical therapy and stretching may be helpful if the quadricep and hamstring muscles are tight, especially after a significant growth spurt.

Rest and inactivity are not of benefit. Sport participation and other activity should be continued as tolerated.

Uncommonly, for those with intractable pain and other symptoms, there may be some surgical options to help. If surgery is contemplated, it is often delayed until the bone growth plates around the knee have closed.

Are there home remedies for Osgood-Schlatter disease?

Once the diagnosis is confirmed, home treatment is ongoing until the inflammation and pain resolves. Ice, over the counter pain medication, and stretching programs will be helpful.

What is the prognosis for Osgood-Schlatter disease?

How long does Osgood-Schlatter disease last?

Osgood-Schlatter is a self-limiting disease and usually resolves in 6-18 months. Often patients can continue with sports and routine activities, but for some, the quality life can be significantly impaired.

Is it possible to prevent Osgood-Schlatter disease?

Osgood-Schlatter disease affects adolescents who have had a growth spurt and have an active lifestyle or participate in sports that involved running and jumping. It may not be preventable, but it can be recognized and treated early.

For those in the midst of a growth spurt, stretching programs to help with flexibility may be helpful.

Medically Reviewed on 4/8/2024
References
Gaulrapp H, Nuhrenborger C. The Osgood-Schlatter disease: a large clinical series with evaluation of risk factors, natural course, and outcomes. Int Orthop. 2022. 46(2):197-204.

Guldhammer C, Rathleff MS, et al.. Long-term Prognosis and Impact of Osgood-Schlatter Disease 4 Years After Diagnosis: A Retrospective Study. Orthop J Sports Med. 2019. 7(10)

Circi, E; Atalay, Y; Beyzadeoglu, T.Treatment of Osgood-Schlatter disease: review of the literature. Musculoskeletal Surgery. 2017.101 (3): 195–200

Bezuglov, E, Tikhonova, ?,etal. Conservative treatment of Osgood-Schlatter disease among young professional soccer players. International Orthopaedics.2020 44 (9): 1737–1743