Medical: Osteochondrosis deformans juvenilis of the tuberosity tibiae, apophysitis tibialis adolescentium, juvenile osteochondrosis of the tibia and fibula, rugby knee
History
In 1903, the American orthopedist Robert Bayley Osgood (1873-1956) and the Swiss surgeon Carl Schlatter (1864-1934) independently published case reports of the disease, which was later named after them.
Summary
Osgood-Schlatter’s disease is a non-infectious (aseptic) death of bone (osteonecrosis) at the tibia at the point where the patellar ligament (patellar tendon) attaches below the patella (tibiaapophysis). Osgood-Schlatter’s disease mainly affects boys between 10 and 14 years of age who are active in sports. The cause is unclear, but there are various theories of its development, e.g. overloading, overweight and local circulatory disorders.
In the case of M. Osgood-Schlatter, the young people mostly feel pain that is dependent on movement and improves when they are at rest. However, there are also asymptomatic courses, which means that the disease is discovered by chance, but there are no complaints. As a therapy, rest and anti-inflammatory measures are usually sufficient. Only in exceptional cases does Osgood-Schlatter disease require surgery. At the latest with growth conclusion the Morbus Osgood-Schlatter heals mostly without consequences.
Cause
The real cause of Osgood-Schlatter’s disease is unknown. It is assumed that, for example, sporting activities, obesity and/or reduced tibial resilience during the hormonal changes in puberty cause an imbalance in the load on the knee or increased tension of the patellar ligament (ligamentum patellae). A further assumption is that overloading or exercise-related micro injuries are the cause, since overweight or particularly athletically active adolescents often suffer from this disease during puberty. It is also possible that M. Osgood-Schlatter is caused by local circulatory disorders.
Symptoms
Different courses of the Osgood-Schlatter disease are observed. Patients often complain of movement-dependent pain when tensing the thigh muscles, when applying manual pressure below the kneecap on the edge of the tibia, when bending and stretching the knee joint. This pain can be accompanied by swelling of the upper tibia.
They improve at rest, but usually do not disappear completely. This pain at rest permanently irritates the knee. It decreases over time, but there is a risk that the knee can no longer be fully loaded.
This results in weakness and the knee “bends away”. There are also completely asymptomatic courses in which Osgood-Schlatter’s disease is only a random finding in the X-ray image. The pain in Osgood-Schlatter’s disease occurs in the front part of the knee (see: anterior knee pain), usually directly below the kneecap.
In this area there is usually a bony protrusion that is particularly painful when pressure is applied. However, they can also become more extensive, especially after loading. The pain generally intensifies after sports or other forms of exercise.
Since the disease itself usually heals on its own, pain therapy is the essential part of the treatment. This is also helped by cooling the knee, which can be done by the patient himself, but also by professional cryotherapy. Also the so-called TENS method and targeted strengthening of the muscles can help to reduce the pain.
Sports after the pain is increased, should be avoided. Painkillers are also used, especially NSAIDs such as ibuprofen or diclofenac, which in addition to pain inhibition also inhibit the inflammatory reaction. Whether externally applied pain gels and ointments help can be tried out. Other complementary treatments, such as massage and stretching of the thigh muscles or acupuncture can also help to reduce the pain.
