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Osgood-schlatters Disease

Osgood-schlatters Disease

Osgood-Schlatter’s disease, which is also called tibial tubercle apophyseal traction injury is a condition concerning the fracture of the growth plate, or upper margin of the tibial tuberosity, the little bone on the upper front part of the tibia or shinbone. This disease is also the condition in which the patellar tendon, the tendon under the kneecap, becomes inflamed due to repeated stress coupled with the growth of the apophyseal plates, causing pain felt all over the muscles and bones that the patellar tendon is attached to. This condition is common in young adolescents aged 10 – 16, especially young boys going through the rapid growth attributed to their age and participating in activities that cause repeated stress to the knee joints like sports activities. This disease is self limiting but treatment is usually needed when the pain and debilitating effects hinders daily activities particularly when both knees are affected.

The condition is called as such because it was named after the two doctors who first identified the disease in 1903, Dr. Carl Schlatter and Dr. Robert Osgood.

Osgood-schlatters disease in children

Osgood-Schlatter’s disease happens more frequently among children in their pre-teen and teen years because this is the time when these young adolescents are going through periods of growth spurts, which makes the immature tibial tuberosity prone to injury. This situation, when combined with frequent strenuous activities that place repeated strain on the patellar tendon, which is connected to the tibial tuberosity. And because the tibial tuberosity is very susceptive at this time, the stress it is subjected to can lead to injury of the bone causing subsequent inflammation and severe pain.

Osgood-schlatters disease in adults

Osgood-Schlatter’s disease in adults is more complicated, this is because the tibial tuberosity has already matured and turned to hard bone. Osgood-Schlatter’s disease in adults may be the after effects of recurrence of the condition that once must have gone through in childhood. The bony bump formed by the tibial tuberosity hardens as we age and a misalignment may impinge nerves, muscles and tendons causing injury and pain. And unlike in children where the bone is still developing and soft, allowing the area to heal itself, the adult bone is already matured and hard, so a reoccurrence of Osgood-Schlatter’s disease in adults usually entails surgery for treatment.

Osgood-schlatters disease Causes

The main risk factor to the occurrence of this disease is repeated stress and trauma to the patellar tendon and tibial tuberosity, the stress can be caused by a number of activities like frequent running, jumping, going up and down stairs, and participating in rough sports where knee injuries are common.

The main reason for this is that these activities make use of the quadriceps muscles on the upper thigh, this powerful muscle pulls on the patellar tendon which goes through the tibial tuberosity, such that frequent and intense use of this muscle will also take its toll on the bone, causing avulsion fractures and tissue inflammation, which ultimately leads to the condition called Osgood-Schlatter’s disease.

Osgood-schlatters disease Symptoms

Signs and symptoms felt by patients with Osgood-Schlatter’s disease, especially the level of pain felt may vary from person to person but some of the most common symptoms are:

  • Tenderness of the knee area and pain that is aggravated during and after activities like exercise.
  • Shooting pain that is concentrated at the tibial tuberosity, or that small bony prominence on the knee
  • Obvious enlargement or inflammation of the knee or the tibial tuberosity
  • Sharp pain when contracting the quadriceps muscles both when bent and straightened.
  • Limping or difficulty in walking after an activity involving use of the legs
  • Calcification of the tendon, as visualized through an x-ray test.

 

Osgood-schlatters disease Complications

Complications of the Osgood-Schlatter disease are usually rare. And if they do actually happen, the complications may consist of prolonged swelling in the knee area, chronic pain, and an overall difficulty in ambulation.  Long term effects may include the formation of a bony lump on the shin bone. This is caused by calcification of the area who suffered frequent trauma.

Osgood-schlatters disease Treatment

Treatment for Osgood-Schlatter’s disease, especially in children, is a conservative one, since the condition is usually self limiting at this age. The primary and most important treatment is providing adequate rest to the affected joint, so that the bone can heal itself properly before being used again. Inflammation can be countered by intermittently placing an ice pack over the affected area and elevating the whole leg. The use of a knee support or knee strap is also recommended when starting to use the leg again and after the knee has been given enough time to heal. Medications like Paracetamol can be given to relieve pain and reduce swelling.

Osgood schlatter brace

An Osgood-Schlatter brace may be any of the products available in the market that is used as an added support for the patellar region. These are straps or braces that are made from a variety of materials from hard plastic and rubber, to neoprene strips. They provide stable therapeutic support during activities but are also loose enough not to impede circulation. Neoprene sleeves for the knee are especially effective because they keep the whole knee area warm, promoting more rapid healing.

Osgood-schlatters disease prevention

The main idea about the prevention of the occurrence of this disease is to avoid the factors that cause it in the first place, like repeated strain and trauma on the joint, but this does not mean that you should stop all sports related activities altogether, you just have to do a little tweaking of the activities to reduce the amount of stress exerted on the area. Some of these techniques are:

  • Correct warming up and stretching techniques before a strenuous activity
  • Gradual and slow increase of activity intensity to allow the muscles to catch up and strengthen before being subjected to intense activities
  • Doing exercises specifically designed and aimed at increasing the strength and tone of the quadriceps muscles for added support.

References:

http://familydoctor.org/online/famdocen/home/children/parents/special/bone/135.html

http://en.wikipedia.org/wiki/Osgood%E2%80%93Schlatter_disease

http://www.medicinenet.com/osgood-schlatter_disease/article.htm#3whatis



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