Osteopathy

Osgood-Schlatter

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About 4% of people are affected at some point in time.

Osgood–Schlatter disease causes pain in the front lower part of the knee.

Intense knee pain is usually the presenting symptom that occurs during activities such as running, jumping, lifting things, squatting, and especially ascending or descending stairs and during kneeling.

Risk factors include overuse, especially sports which involve running or jumping.

This test can see various warning signs that predict if OSD might occur. Ultrasonography can detect if there is any tissue swelling and cartilage swelling.

OSD may result in an avulsion fracture, with the tibial tuberosity separating from the tibia (usually remaining connected to a tendon or ligament). This injury is uncommon because there are mechanisms that prevent strong muscles from doing damage. The fracture on the tibial tuberosity can be a complete or incomplete break.

Type II: The articular surface of the tibia remains intact and the fracture occurs at the junction where the secondary center of ossification and the proximal tibial epiphysis come together (may or may not require surgery).

Type III: Complete fracture (through articular surface) including high chance of meniscal damage. This type of fracture usually requires surgery.

Sinding-Larsen and Johansson syndrome,

One of the main ways to prevent OSD is to check the participant’s flexibility in their quadriceps and hamstrings. Lack of flexibility in these muscles can be direct risk indicator for OSD. Muscles can shorten, which can cause pain but this is not permanent.

Direct stretching of the quadriceps can be painful so the use of foam rolling for self myofascial release can help gently restore flexibility and range of movement

Treatment is generally conservative with rest, ice, and specific exercises being recommended.

Bracing or use of an orthopedic cast to enforce joint immobilization is rarely required and does not necessarily encourage a quicker resolution. However, bracing may give comfort and help reduce pain as it reduces strain on the tibial tubercle.

Surgical excision may rarely be required in people who have stopped growing.

Rehabilitation focuses on muscle strengthening, gait training, and pain control to restore knee function.

Isometric exercises, such as isometric leg extensions, have been shown to strengthen the knee,

Other exercises can include leg raises, squats, and wall stretches to increase quadriceps and hamstring strength. This helps to avoid pain, stress, and tight muscles that lead to further injury that oppose healing.

The symptoms usually resolve with treatment but may recur for 12–24 months before complete resolution at skeletal maturity, when the tibial epiphysis fuses. In some cases the symptoms do not resolve until the patient is fully grown. In approximately 10% of patients the symptoms continue unabated into adulthood, despite all conservative measures.

OSD occurs from the combined effects of tibial tuberosity immaturity and quadriceps tightness.

Of people admitted with OSD, about half were children who were between the ages of 1 and 17. In addition, in 2014, a case study of 261 patients was observed over 12 to 24 months. 237 of these people responded well to sport restriction and non-steroid anti-inflammatory agents, which resulted in recovery to normal athletic activity.

Par antoinelzch, publié le
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