Adolescent Knee Pain - Osgood Schlatter Disease

Has your adolescent son or daughter been diagnosed with Osgood Schlatter disease? If so, you may be interested in learning more about the cause and treatment of this common orthopedic problem.

Osgood Schlatter disease was first discovered around the turn of the century by Paget and was later described by two physicians, Osgood and Schlatter, who gave it its name. The disease occurs when the growth of the femur (large bone in the thigh) outpaces the growth of the surrounding supporting tissues. This results in excessive stress being placed on the patella tendon which connects to the tibial tuberosity, located just below the knee cap. The associated stress may set up an inflammatory process, resulting in a partial avulsion fracture. As new bone is laid down to repair the fracture, a bony lump may form at the tibial tuberosity. This bony lump formed is often red and painful to the touch.

Osgood Schlatter disease is a well described cause of knee pain in adolescent girls and boys. In fact, it’s one of the most common causes of knee pain in adolescents who actively participate in sports. It’s most often seen in girls between the ages of 10 and 11 and in males between the ages of 13 and 14. The affected adolescent frequently presents to his or her doctor with tenderness and swelling just below the knee along with pain when jumping, squatting, or going up and down stairs.This disease, although usually benign and self limited, is of particular concern to the adolescent and his family since it may limit the ability of the child to play his chosen sport. In fact, the average adolescent suffering from Osgood Schlatter disease loses up to 18 months sports play time due to pain from this condition.

It may surprise you to learn that up to 20% of athletic adolescents may be affected with Osgood –Schlatter disease. We know that Osgood Schlatter is more common in males, although it can occur in females. It’s most commonly seen during periods of rapid skeletal growth in adolescents who are active in sports, particularly sports involving running and jumping. The repeated process of running and jumping may contribute to the development of the disease by placing excessive strain on the patella tendon that attaches to the tibial tuberosity.

The diagnosis is usually made clinically by a doctor based on the child’s symptoms. An x-ray may be taken to look for evidence of an enlarged tibial tuberosity or the presence of bony fragments from the tibial tuberosity. An x-ray may also be used to distinguish this condition from several other knee related problems which give similar symptoms.

This condition is usually benign and will resolve on its own when the adolescent completes his growth spurt, which usually takes less than a year. Until then, activity levels are based primarily on the severity of symptoms which should be determined with the help of a doctor. Usually the adolescent is instructed to forgo sporting activities that require deep knee bending for at least 3 months. Anti-inflammatory medications are prescribed if the adolescent is able to tolerate them to reduce the pain and inflammation associated with the disease. Application of ice for 15 minutes every 3 hours also helps to reduce the pain and inflammation. Once the acute symptoms have subsided, the doctor may suggest exercises for stretching the quadriceps to reduce the tension on the affected tibial tubercle. In rare cases, surgery may be necessary for cases unresponsive to conventional therapy .Occasionally, an orthopedic brace may be needed if symptoms are severe.

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