Osgood-Schlatter’s is a disorder that causes pain at the tibial tuberosity, which is the bump on the front of the knee, just below the kneecap where the patellar tendon attaches. It is generally a self-limited problem and does not lead to long-term consequences. Most athletes with Osgood-Schlatter’s will improve with a short period of rest. The problem is due to pulling of the tendon on the growth plate. Some theories of Osgood-Schlatter’s suggest that there are microfractures of the growth plate in this area.
Osgood-Schlatter’s occurs in children with open growth plates (still growing) and particularly affects active children, especially those athletes who participate in jumping or sprinting sports. Osgood- Schlatter’s is more common in boys. The growth plate is most vulnerable during periods of rapid growth and therefore the incidence in boys peaks at age 13 and at age 12 in girls. It is usually caused by overuse but can also be initiated by a sudden injury.
A physician often can simply diagnose the problem by taking a history and palpating the tender area. The knee area is tender and may be swollen or enlarged. X-rays may reveal widening of the growth plate in this area. An MRI is usually not necessary.
Activity modification is the main treatment for Osgood-Schlatter’s. Other conservative treatment measures include ice, stretching, controlled strengthening, simple over-the counter pain medicines, and a patellar strap. In more severe cases, a short period of casting or bracing may be recommended. Surgery is almost never necessary, except in adults with persistent symptoms.
The symptoms of Osgood-Schlatter’s almost always improve with rest and also usually subside when the athlete reaches skeletal maturity (fully grown). In rare cases, a fragment of bone may not unite to the underlying tibia and symptoms may persist into adulthood. In this situation, the pain can be alleviated by a simple operation to remove the fragment. Although extremely rare, an athlete who continues to play vigorous sports with persistent pain from Osgood-Schlatter’s may develop a complete fracture through the growth plate at the top of the tibia. Usually, however, the only long-term consequence of Osgood-Schlatter’s is a residual bump on the front of the knee cap which does not interfere significantly with sports..
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