Osgood-Schlatter disease

Osgood Schlatter disease is a frequent reason for consultation in traumatology during childhood and adolescence. The cause of the disease is unknown, although it is considered to be an overuse injury. The repeated contraction of the knee extensor apparatus (quadriceps muscle) is probably secondary to the microtrauma caused on the insertion area of ​​the patellar tendon (anterior tibial tuberosity). One of the data that support this theory is their age of onset (between 8 and 15 years old) and the affected population group, which tend to be more frequent in sporty children, very active and during or after sports activity. It occurs more frequently in males (3: 1).

• It is considered an overuse injury that is a frequent reason for consulting a traumatologist and that affects children more, especially if they play sports.
• The main and characteristic symptom is pain that, although it may persist for several months, which disappears with treatment.
• Treatment is conservative because it has a very good prognosis, and is based on stretching, cryotherapy, and symptomatic pain relief.

Good prognosis

Although the pain may persist for several months, the prognosis is excellent with resolution of the condition when a ossification of the growth plate. In some cases, pain and discomfort may persist in adults, although there are no sequelae or major complications.

What are the main symptoms?

The main and characteristic symptom is the appearance of intense pain in the lower knee area after sports or physical activity. Sometimes some swelling or redness may appear. The pain usually subsides with rest. It can be only bilateral and worse when running, jumping, climbing or descending stairs.

How is it diagnosed and what is the treatment?

The diagnosis is based mainly on the clinical characteristics (symptoms, age of the patient) and the physical examination, where some maneuvers are usually painful. On palpation in most cases there is pain in the anterior tibial tuberosity. It may be indicated to rule out other causes of pain. While other more sophisticated examinations (such as MRI) are not necessary. Given the good prognosis, treatment is conservative. The goal is to maintain physical activity as much as possible but to eliminate pain.

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It is recommended:

• Perform specific stretches (quadriceps stretching) before sports activity.
• In acute periods of pain, apply ice for 20 minutes every 2-4 hours on the painful area.
• Anti-inflammatories.
• Decreased physical activity (but not prolonged immobilization).
• In very severe cases, immobilization can be performed for a short period until improvement.
• Other treatments such as infiltrations are not indicated.
• Surgery is usually reserved for very specific cases, especially in adults with persistent symptoms.