eMedicine Specialties > Sports Medicine > Lower Limb

Osgood-Schlatter Disease: Follow-up

Author: Munisha Mehra Bhatia, MD, General Academic Pediatrics, Faculty Development Fellow, Children's Memorial Hospital of Northwestern University
Coauthor(s): Janos P Ertl, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Chief of Orthopedic Trauma, University of California at Davis; Director of Amputee Clinic, Kaiser Hospital; Gyorgy Kovacs, MD, Department of Orthopedic Surgery, Consulting Surgeon, GOC Clinic
Contributor Information and Disclosures

Updated: Apr 28, 2006

Follow-up

Return to Play

After the pain has resolved (which may take 6-24 mo), the patient may return to play as tolerated. The patient may need to participate less frequently, run at a slower speed, or decrease jumping activities. Premedicating or relying on NSAIDs regularly before or after competition is not advised. An intensive rehabilitation program of stretching exercises helps to decrease the likelihood of developing pain with vigorous sports activity. OSD usually resolves by the time the adolescent is aged 18 years.

Complications

The most common long-term complications are pain on kneeling as an adult and the cosmesis of a bony prominence on the anterior knee. Less common complications are the persistence of a painful ossicle requiring surgical excision and a displaced avulsion of a tibial tubercle.

Prevention

Activity modification and regular stretching and strengthening exercises provide the best prevention.

Prognosis

The prognosis is excellent. OSD usually resolves by the time the patient is aged 18 years, when the tibial tubercle apophysis ossifies. The likelihood for long-term sequelae increases in severe cases, in cases in which treatment is not sought, or in cases in which the patient demonstrates poor compliance with the physician's recommendations.

Education

OSD is a self-limited illness that resolves as the patient approaches adulthood. For acute flare-ups, anti-inflammatory medications, ice, elevation, and rest are recommended. For prevention, the patient should engage in activity and sports as tolerated without development of knee pain. Regular daily stretching and strengthening exercises should be performed to help prevent OSD. Inform patients regarding the activities that aggravate the condition and regarding the self-limiting nature of the disease.

For excellent patient education resources, visit eMedicine's Foot, Ankle, Knee, and Hip Center, Arthritis Center, and Bone Health Center. Also, see eMedicine's patient education article Knee Pain.

Miscellaneous

Medicolegal Pitfalls

  • The most significant medicolegal pitfall is failing to diagnose another condition that could result in long-term permanent damage (eg, tumor, osteochondritis dissecans). Most other conditions have a more concerning clinical examination or history. Therefore, always obtain radiographs and consider the possibility of a referred pain syndrome from the hip.

Special Concerns

  • If a patient is noncompliant, the clinician may recommend immobilization in a knee brace for a minimum of 6 weeks. The brace should be removed daily, only for stretching and strengthening exercises.
 


More on Osgood-Schlatter Disease

Overview: Osgood-Schlatter Disease
Differential Diagnoses & Workup: Osgood-Schlatter Disease
Treatment & Medication: Osgood-Schlatter Disease
Follow-up: Osgood-Schlatter Disease
Multimedia: Osgood-Schlatter Disease
References
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References

  1. Behrman R, Kliegman R, Nelson WE. Osgood-Schlatter disease. In: Nelson Textbook of Pediatrics. Vol 14. Philadelphia, Pa: WB Saunders; 1992:1705.

  2. Bloom OJ, Mackler L, Barbee J. Clinical inquiries. What is the best treatment for Osgood-Schlatter disease?. J Fam Pract. Feb 2004;53(2):153-6. [Medline].

  3. Demirag B, Ozturk C, Yazici Z, Sarisozen B. The pathophysiology of Osgood-Schlatter disease: a magnetic resonance investigation. J Pediatr Orthop B. Nov 2004;13(6):379-82. [Medline].

  4. Epstein B. Common problems affecting adolescents - Osgood Schlatter disease: A common cause of knee pain. In: Iowa Health Book: Family Practice. Iowa City, Iowa: The University of Iowa; 1995.

  5. Flowers MJ, Bhadreshwar DR. Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. J Pediatr Orthop. May-Jun 1995;15(3):292-7. [Medline].

  6. Meisterling R, Wall E, Meisterling M. Coping with Osgood-Schlatter disease. In: The Physician and Sports Medicine. Vol 26. New York, NY: McGraw-Hill; 1998.

  7. Ross MD, Villard D. Disability levels of college-aged men with a history of Osgood-Schlatter disease. J Strength Cond Res. Nov 2003;17(4):659-63. [Medline].

  8. Staheli L. 2nd ed. Fundamentals of Pediatric Orthopedics. Philadelphia, Pa: Lippincott-Raven; 1998:56, 123.

  9. Tachdjian MO. Clinical Pediatric Orthopedics: The Art of Diagnosis and Principles of Management. Vol 1. Stamford, Conn: Appleton & Lange; 1997:107-108.

  10. Wall E. Osgood-Schlatter disease: Practical treatment for a self-limiting condition. In: The Physician and Sports Medicine. Vol 26. New York, NY: McGraw-Hill; 1998.

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Further Reading

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Keywords

OSD, tibial tubercle osteochondrosis, traction apophysitis, knee pain

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Contributor Information and Disclosures

Author

Munisha Mehra Bhatia, MD, General Academic Pediatrics, Faculty Development Fellow, Children's Memorial Hospital of Northwestern University
Munisha Mehra Bhatia, MD is a member of the following medical societies: Ambulatory Pediatric Association and American Academy of Pediatrics
Disclosure: Nothing to disclose.

Coauthor(s)

Janos P Ertl, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Chief of Orthopedic Trauma, University of California at Davis; Director of Amputee Clinic, Kaiser Hospital
Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Hungarian Medical Association of America, Orthopaedic Trauma Association, and Sierra Sacramento Valley Medical Society
Disclosure: Nothing to disclose.

Gyorgy Kovacs, MD, Department of Orthopedic Surgery, Consulting Surgeon, GOC Clinic
Disclosure: Nothing to disclose.

Medical Editor

Andrew L Sherman, MD, Associate Professor, Departments of Neurological Surgery, Orthopedics, and Rehabilitation, University of Miami Miller School of Medicine
Andrew L Sherman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Sports Medicine, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Marlene DeMaio, MD, Consulting Staff, Department of Orthopedic Surgery, Assistant Professor, Bone & Joint/Sports Medicine Institute, Naval Medical Center
Marlene DeMaio, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Orthopaedic Foot and Ankle Society, and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

CME Editor

Jon Whitehurst, MD, Consulting Staff, Rockford Orthopedic Associates
Disclosure: Nothing to disclose.

Chief Editor

William Jay Bryan, MD, Clinical Professor, Department of Orthopedic Surgery, Baylor University College of Medicine
William Jay Bryan, MD is a member of the following medical societies: Texas Orthopaedic Association
Disclosure: Nothing to disclose.

 
 
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