Osgood-Schlatter Syndrome

What is it?

Osgood-Schlatter syndrome (or disease) is a painful knee condition that tends to affect adolescents. Boys are affected more than girls, although this could be due to differing activity patterns. It is thought that around 13 per cent of adolescent knee pain is due to Osgood-Schlatter syndrome.

It often occurs during a growth spurt and is associated with physical activity. It is thought that the tendon attaching the quadriceps muscles to the shin bone becomes tight and causes inflammation and micro-fractures in the tibial tuberosity.

The tibial tuberosity swells and feels painful during certain activities such as running, kneeling, or stair climbing. Osgood-Schlatter syndrome usually resolves by itself with time. 

The symptoms of Osgood-Schlatter syndrome depend on the severity of the condition, but may include:

• Pain in one or both knees

• Pain when straightening the knee joint or full squatting

• Pain on running, or going up and down stairs

• Pain that eases with rest

• Swollen tibial tuberosity

• Red and inflamed skin over the tibial tuberosity

• Quadriceps muscles that can sometimes lose strength and bulk.

Mechanism of Injury

Some of the causes of Osgood Schlatter syndrome may include:

• Growth spurt – the condition tends to affect adolescent children. Affected boys are often aged about 13 to 14 years, while affected girls are often aged 10 to11 years.

• Exercise – active children, particularly those engaged in athletics and sports, are at increased risk.

• Gender – boys are more susceptible than girls, but perhaps this is because boys typically play more vigorous sports.

•  Injury – around half of all children with the condition report a prior knee injury.

Common Management Techniques

Conservative Management

• Activity modification or relative rest – completely avoiding activities that are painful for at least a couple of weeks followed by gradual return to activity guided by symptom levels

• Frequent use of icepacks to reduce the local pain and swelling

• Stretching and strengthening exercises for the quadriceps, hamstring and calf muscles – a suitable program can be provided by a physiotherapist

• Medications, including painkillers and anti-inflammatory drugs

Surgical Management

• In rare circumstances, surgery may be required – but this is only in extreme cases and only once growth has ended

Prognosis

Osgood-Schlatter syndrome usually resolves by itself within 12 months. However, the knee may remain uncomfortable until the growing finishes.