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Osgood Schlatter Disease

Osgood Schlatter Disease, also known as "Knobby Knees" is actually not a disease at all, but rather an overuse syndrome. This condition is named after two Orthopaedic Surgeons (Robert Osgood, Carl Schlatter) who discovered it. It is the most common cause of knee pain in adolescents.

What is Osgood Schlatter Disease?

Osgood Schlatter Disease (OSD) is a chronic inflammation of one of the knee ligaments, called the "Patellar Ligament" where it anchors to the Tibia Bone (Tibial Tuberosity) just below the Knee Joint. Repetitive activities such as sports (soccer, basketball, football, volleyball, gymnastics) cause strain on this ligament which in turn irritates the bone where it attaches. It is thought that overuse of the quadriceps muscle in the front of the thigh is the main culprit of OSD. The Knee Joint itself or its function is not involved in OSD.

Who Gets Osgood Schlatter Disease?

This condition is common in adolescents at the beginning of their growth spurt: Girls ages 8-13; Boys ages 10-15. It is uncommon for a teenager to develop OSD after the age of 16. Boys are more likely to develop OSD than girls. Athletes are far more common to get OSD than those not consistently involved in sports.

What are the common Symptoms of Osgood Schlatter Disease?

Patients usually develop pain and swelling just below the Knee Joint. This is due to the inflammation of the Patella Ligament and the Bone where the Ligament attaches to the Tibia.

The pain is commonly worse after exercise since this irritates the ligament and bone. In the early stages of the disease, the symptoms are usually mild and intermittent. Later, it can be more consistent even without straining the knee.

What are the potential Complications of Osgood Schlatter Disease?

Some OSD patients develop small fractures (avulsion fracture) of the excess bone callus which forms in the front of the Tibia at the Tibial Tuberosity. This is called an "avulsion fracture".

How is Osgood Schlatter Disease treated?

OSD usually resolves on its own over the course of several months. However in some patients the symptoms can last for much of the growth spurt, but rarely beyond. The most important treatment is to either avoid or limit the physical activity (sports, etc.) which causes the symptoms. During painful episodes, ice and mild anti-inflammatory medications can help. Wearing Knee pads during sports is also helpful.

Hamstring and Quadriceps stretches can balance the muscles, ligaments and tendons around the Knee Joint. The "Strickland Protocol" has been shown to reduce the downtime from sports activities significantly. This protocol is a combination of myofascial release massage and quadriceps stretches.

Surgery is rarely needed for OSD and is reserved for severe or long-term cases lasting past the growth spurt. The Surgery removes the excess bone which has formed on the Tibial Tuberosity. The outcomes of this Surgery are reported to be quite good.

The long-term consequences of OSD are usually limited to a bump below the Knee. Some mild knee pain with kneeling can remain into adulthood.