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Osgood Schlatter Disease In Adults

In this article we describe everything you need to know about osgood schlatter disease in adults and the best ways to treat the condition.

Osgood Schaller disease, which is also referred to as Osteochondrosis, or Apophysitis of the knee cap, is among the most common causes of knee pain. It is associated with irritation of the growth plate. This condition is a common cause of anterior knee pain in individuals who play contact sports like Football, Basketball, Volleyball, and gymnastics. It is also common in adolescents, just when they hit their growth spurts. The anterior knee pain by these individuals is also commonly associated with patellar tendon tenderness, particularly at the tibial tuberosity. The tibial tuberosity is the point where the patellar tendon attaches to the top of the shin bone. The triggering factors considered for this most commonly include jumping and sprinting. The healthcare physician most often recommends treatment options like NSAIDs, R.I.C.E, and activity modifications. (1) (2) (3)

Osgood Schlatter Disease Causes

Osgood Schlatter’s Disease is most commonly associated with overuse injuries in adolescent individuals. This overuse injury is caused by repetitive micro-traumas imposed by strains applied by the patellar tendons on the tibial tubercle. Some string forces may even cause slight avulsion injuries of the tibial tubercle apophysis. Additional factors that may increase the risk of injury include inadequate flexing ability of the hamstring muscles or quadriceps muscles, which may lead to misalignment. It may also be caused by bone fragments in the knee joint. (4) (5) (6)

Symptoms of Osgood Schlatter Disease in Adults

The symptoms which are most commonly associated with Osgood Schlatter disease include swelling and anterior knee pain. The anterior knee pain associated with this condition is usually dull in nature and localized to the area of injury. The pain is usually felt over the tibial tubercle but may spread to other parts of the leg. This pain is also usually triggered by activity, which may include running, jumping, squatting, kneeling, and even a direct blow to the knee. The pain is reported to decrease with rest or lowering the level of physical activity. The pain may also radiate to the thigh muscles.

How is Osgood Schlatter’s Disease Diagnosed?

Osgood Schlatter’s disease is commonly diagnosed by taking a detailed medical history and thorough medical examination. As the clinical diagnosis of the condition is adequate, a majority of the experts do not see the need to conduct radiographic tests. These imaging tools may only be required in the rare cases of traumatic injury or sports injuries and are more focused on the tibial tubercles and surrounding soft tissues. (7) (8)

A diagram of Osgood Schlatter disease in adults

Treatment Options For Osgood Schlatter Disease in Adults

Treatment of Osgood Schlatter’s Disease depend on the cause of the disease and the unique health factors of the affected patient. Even though the condition is considered to be self-limiting in most cases, however, the doctor may still recommend various remedies aimed at improving the symptoms and accelerating the healing process. These include:

  •     R.I.C.E: Rice stands for Rest, Ice, Compression, and Elevation and is recommended by the majority of experts as the initial management for Osgood Schlatter’s Disease. The individual is required to either give up on the heavy sports or extensive exercise routines for a short while or modify the activity levels. While there is no proof that reducing sports activity and rest may on its own cause the treatment of the condition, it may help reduce the pain levels and prevent further progression. The icing may be done by using ice packs or cold packs to reduce swelling. (9)
  •     Anti-inflammatory Drug Therapy: NSAIDs like Ibuprofen are also recommended by experts specializing in orthopedics. These may help improve the pain and swelling in the affected area by reducing the levels of inflammation.
  •     Physical Therapy: Physiotherapy conducted by a trained physiotherapist is considered one of the most effective conservative management options for Osgood Schlatter’s disease. The physical therapist may also recommend a knee pad which is to be worn during the healing period in order to protect the area from further damage. (10)

Unresolved Osgood-Schlatter disease may require surgical intervention by an orthopaedic surgeon, who may conduct an ossicle excision.

Prolotherapy:

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat the root cause of Osgood Schlatter in adults.

Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.

Prolotherapy involves injecting a natural regenerative solution with small needles, which has been shown to stimulate the production of collagen cells, the small cells the body uses to repair structures in and around the knee.

As prolotherapy is helping to treat the root cause of Osgood Schlatter, it is deemed to be a permanent fix, preventing the symptoms from returning.

What condition can Osgood Schlatter be confused with?

Osgood Schaller may be confused with numerous other conditions, which include Patella Tendinitis, Synovial Plica Injury, Infectious Apophysitis, Osteomyelitis of Tibia, and Perthes Disease.

 

Frequently Asked Questions

Can Osgood-Schlatter cause permanent damage?

Osgood Schlatter is considered a self-limiting injury, and in the majority of the cases, it does not cause permanent damage. The individual may experience improvement in their symptoms once they stop the triggering activity. It may also be seen to improve after the growth spurt is over in adolescents. Some individuals may present with a permanent bump on their shin bone at the points of the tendon insertion.

 What happens if you don’t treat Osgood-Schlatter?

Osgood Schlatter’s disease is not considered with long-term implications and may resolve on its own. In some rare cases, the growing children with this condition may report a permanent dull pain or constant swelling, which does not resolve.

What are the long-term effects of Osgood-Schlatter disease?

There are no common long-term effects of Osgood Schlatter disease. Some children may experience long-term pain or swelling that is persistent in nature. However, they may find relief from over-the-counter anti-inflammatory medications or applying ice packs to the affected area.  

Does Osgood-Schlatter show up on x-ray?

Radiographs like x-rays are usually not recommended for the diagnosis of Osgood Schlatter’s disease, as this is based upon clinical examination and details medical history. However, Osgood Schlater’s disease, which is caused by a traumatic injury, may require a radiographic examination to rule out other causes of knee pain like patella fracture.

Does Osgood-Schlatter show up on MRI?

The changes in the patellar tendon associated with Osgood Schlatter disease may be visualized on the M.R.I., as this type of imaging technique is highly sensitive to soft tissues.

What causes Osgood-Schlatter flare-up?

Flare-ups of Osgood Schlatter are mostly caused by irritation in the growth plate of the bone in adolescents. These are located at the end of the bones, where they joint the joint. Irritation of the growth plate can be caused by a number of factors like overuse, trauma, and indulging in jumping or contact sports.

References

  1.   Rathleff, M. S., Straszek, C. L., Blønd, L., & Thomsen, J. L. (2019). Ugeskrift for laeger, 181(13), V01180081.
  2.   Murphy, C. E., & Kenny, C. M. (2019). Not just for boys: a rare case of symptomatic Osgood-Schlatter disease in a skeletally mature woman. B.M.J. case reports, 12(3), e228963. https://doi.org/10.1136/bcr-2018-228963
  3.   Seyfettinoğlu, F., Köse, Ö., Oğur, H. U., Tuhanioğlu, Ü., Çiçek, H., & Acar, B. (2020). Is There a Relationship between Patellofemoral Alignment and Osgood-Schlatter Disease? A Case-Control Study. The journal of knee surgery, 33(1), 67–72. https://doi.org/10.1055/s-0038-1676523
  4.   Hart, E., Meehan, W. P., 3rd, Bae, D. S., d’Hemecourt, P., & Stracciolini, A. (2018). The Young Injured Gymnast: A Literature Review and Discussion. Current sports medicine reports, 17(11), 366–375. https://doi.org/10.1249/JSR.0000000000000536
  5.   Midtiby, S. L., Wedderkopp, N., Larsen, R. T., Carlsen, A. F., Mavridis, D., & Shrier, I. (2018). Effectiveness of interventions for treating apophysitis in children and adolescents: protocol for a systematic review and network meta-analysis. Chiropractic & manual therapies, 26, 41. https://doi.org/10.1186/s12998-018-0209-8
  6.   Watanabe, H., Fujii, M., Yoshimoto, M., Abe, H., Toda, N., Higashiyama, R., & Takahira, N. (2018). Pathogenic Factors Associated With Osgood-Schlatter Disease in Adolescent Male Soccer Players: A Prospective Cohort Study. Orthopaedic journal of sports medicine, 6(8), 2325967118792192. https://doi.org/10.1177/2325967118792192
  7.   Gholve, P. A., Scher, D. M., Khakharia, S., Widmann, R. F., & Green, D. W. (2007). Osgood Schlatter syndrome. Current opinion in pediatrics, 19(1), 44–50. https://doi.org/10.1097/MOP.0b013e328013dbea
  8.   Patel, D. R., & Villalobos, A. (2017). Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Translational pediatrics, 6(3), 190–198. https://doi.org/10.21037/tp.2017.04.05
  9.   van den Bekerom, M. P., Struijs, P. A., Blankevoort, L., Welling, L., van Dijk, C. N., & Kerkhoffs, G. M. (2012). What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?. Journal of athletic training, 47(4), 435–443. https://doi.org/10.4085/1062-6050-47.4.14
  10. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Physical therapy. 2020 Aug 27. Available from: https://www.ncbi.nlm.nih.gov/books/NBK561514/

 

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