What are the other Names for this Condition? (Also known as/Synonyms)

• OSD (Osgood-Schlatter Disease)
• Osteochondrosis of the Tibial Tubercle
• Tibial Tubercle Apophysitis

What is Osgood-Schlatter Disease? (Definition/Background Information)

• Osgood-Schlatter Disease (OSD) is caused by inflammation of the patellar (kneecap) ligament located at the tibial tuberosity around the knee joint. The tibial tuberosity is the bony protrusion of the shinbone, near the knee
• The condition is mostly seen in children during late childhood or early puberty (usually after age 9 years) and occurs from repeated injury to the growth plate (below the kneecap), which is aggravated by sports activities such as running and jumping
• The signs and symptoms of Osgood-Schlatter Disease include pain below the knee joint, which often gets worse with activity but better with rest. The painful episodes can last from few weeks to several months. Usually, only one knee is affected; but often both the knees can present pain
• There are 3 types of Osgood-Schlatter Disease and these include:
  • Osgood-Schlatter Disease Type 1: In this condition, a small fragment of avulsed fracture bone from the tibial tuberosity is displaced proximally.  This condition usually does not require any surgical intervention
  • Osgood-Schlatter Disease Type 2: In this condition, the articulating surface of the tibial bone is unaffected, and the fracture often occurs in the region where the tibial epiphysis meets the secondary center of ossification. This type may occasionally require surgical treatment
  • Osgood-Schlatter Disease Type 3: In this condition, there is a complete avulsion fracture through the articular surface resulting in surrounding damage to the meniscal cartilage. This type of fracture is often treated through surgery
• The prognosis of Osgood-Schlatter Disease is dependent upon an early diagnosis and prompt treatment if the condition but is mostly good. Children outgrow the condition when they reach teenage

Who gets Osgood-Schlatter Disease? (Age and Sex Distribution)

• Typically, the age range of manifestation of Osgood-Schlatter Disease is around 10 to 15 years
• OSD affects males more than females: Some studies have shown the male-female ratio to range from 3:1 to as much as 7:1
• The disorder is seen all over the world; there is no particular geographical restriction noted. No ethnic or racial preference is seen

What are the Risk Factors for Osgood-Schlatter Disease? (Predisposing Factors)

The common risk factors for Osgood-Schlatter Disease include:

• Playing sports such as soccer, basketball, and volleyball
• Long distance running
• Individuals (children) who participate in gymnastics
• Osgood-Schlatter Disease usually affects young children and teenagers, especially those participating in athletic activities such as jumping

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Osgood-Schlatter Disease? (Etiology)

The exact cause of Osgood-Schlatter Disease is unknown. However, it is believed that the pain and inflammation is caused by repeated stress to the growth plate of the upper tibia (shinbone). There is an overuse of the thigh muscle before the bone growth is complete. Thus, the condition can be termed as an overuse injury.

• The disease is prone to occur in children when there is a growth spurt resulting in bone growth faster than soft tissue growth
• This may result in muscle tendon tightness across the joint and loss of flexibility. This traction may result in avulsion fracture of the tubercle
• When the fracture heals, secondary bone forms at the site resulting in swelling

What are the Signs and Symptoms of Osgood-Schlatter Disease?

• The signs and symptoms of Osgood-Schlatter Disease include pain that tends to increase and decrease (get better over time); waxing and waning
• Usually, one knee joint is affected; but, in about 30% of the individuals the pain can be bilateral
• Pain below the knee joint and over the tubercle (bony protrusion)
• Pain aggravates on straightening the knee joint and during activities such as running or climbing stairs
• Swelling of the tubercle and surrounding soft tissue

How is Osgood-Schlatter Disease Diagnosed?

The diagnosis of Osgood-Schlatter Disease is usually based on the location of pain and the pattern of symptoms. OSD may be diagnosed by the following observations and tests:

• X-ray of the knee joint
• Ultrasound scan of knee joint
• MRI studies of the knee joint

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Osgood-Schlatter Disease?

The complications of Osgood-Schlatter Disease may include:

• Presence of fractures in the articulating surface of the knee joint can result in osteoarthritis
• Over time, the fractured bone fragments can become necrotic resulting in bone infarcts, which can continue to cause significant pain and restricted mobility of the knee joint

How is Osgood-Schlatter Disease Treated?

The treatment of Osgood-Schlatter Disease may involve the following measures:

• Resting from athletic activities
• Applying cold compressions to the painful area
• Stretch exercise for the leg (thigh and shin) muscles: Regular stretching and exercise that help in strengthening the muscles around the knee joint; this will help decrease the episodes of pain
• Use of pain medications, such as NSAIDs (ibuprofen)
• Changing the type of activity can also help, such as swimming and walking, instead of running and jumping
• Physical therapy is also helpful in strengthening the muscles around the knee joint and decreasing the frequency of signs and symptoms
• Use of knee immobilizer for support
• In rare cases, casting of the legs may be necessary, to decrease the mobilization around the knee joint

How can Osgood-Schlatter Disease be Prevented?

In some cases, prevention of Osgood-Schlatter Disease may be possible by considering the following measures:

• Stretching before exercises
• Adequate resting between episodes of exercises
• Recognition of the condition and early treatment will help prevent worsening of the signs and symptoms

One of the most important steps in preventing the Osgood-Schlatter Disease is by educating the individual on the condition and helping him/her recognize the signs and symptoms early.

What is the Prognosis of Osgood-Schlatter Disease? (Outcomes/Resolutions)

• The prognosis of Osgood-Schlatter Disease is usually excellent with early recognition and treatment of the condition
• With appropriate treatment, the condition gets better and episodes of pain decreases
• Commonly, the condition resolves when the bone growth is complete; typically, when a child reaches 18 years of age (it may subside even earlier)

However, if Osgood-Schlatter Disease is not recognized promptly and treated early and adequately, the pain may last into adulthood resulting in a significant decrease in one’s quality of life.

Additional and Relevant Useful Information for Osgood-Schlatter Disease:

Osgood-Schlatter Disease derives its name from two surgeons who described this pediatric condition concurrently in 1903, namely Robert Osgood (1873-1956) of US and Carl Schlatter (1864-1934) of Switzerland.