Sydney Copeland: Osgood Schlatters
Pathology
- Osgood Schlatters occurs during growth spurts and puberty
- The medical definition is Apophysistis characterized by pain at the attachment of the patellar tendon to the tibial tuberosity.
>apophysitis-inflammation of the apophysis
>apophysis-any outgrowth or swelling, especially a bony outgrowth that has never been entirely separated from the bone of which it forms a part, such as a process, tubercle, or tuberosity - Represents an avulsion fracture of the tibial tuberosity
>avulsion fracture-separation of a small fragment of bone cortex at the site of attachment of a ligament or tendon - The fragment is cartilaginous initially, but with growth, a bony callus forms and the tuberosity enlarges.
- Only remnant is an enlarged tibial tuberosity
What happens....
Each long bone in your body has a growth plate made of cartilage. Cartilage is not as strong as bone, and when stress is put on the growth plate (which is cartilage), it causes it to become painful and swell. This is what Osgood Schlatters is. During activities your quads pull on the Patellar tendon that connects the patella to the tibial tuberosity. This repeated stress can cause the patellar tendon to pull away from the shinbone, resulting in the pain and swelling. Your body will then close the gap with new bone growth, which is why people who have Osgood Schlatters usually have a large bump under their knee.
General Facts
- More common for boys than girls, because boys are more active at this age
- affects 1 in 5 adolescent athletes
- Age ranges: girls go through puberty before boys
Girls 11-12
Boys 13-14 - resolves when the child's bones stop growing
Signs and symptoms
- Repeated irritation
- Swelling
- Tenderness
- Tightness of surrounding muscles
- Severe pain when playing sports
- Point tenderness over the anterior proximal tibial tuberosity
Structures Involved
- Quads
- Patella
- Patellar tendon
- Tibial tuberosity
- Growth plate
- Tibia
Special Test
A doctor will perform a physical examination and check for tenderness, swelling, pain, redness, and range of motion of the knee and hip. He may also do an x-ray to examine where the kneecap attaches to the shinbone.
Treatment
- Rest the joint
- Patellar tendon strap
>this fits right below the kneecap. It helps "tack down" the patellar tendon during activities and it will also distribute some of the strain away from the shinbone. - Ice
- Stretch leg muscles
- Protect the knee
- Cross-train
Medication
- Acetaminophen and Ibuprofen
Rehab
These exercises are to strengthen the quads and hamstrings, which will help reduce the tension on the patellar tendon. Also used for stabilization.
Misunderstandings of Osgood Schlatters
- You cannot injure/damage your knee more by being active while having Osgood Schlatters.
- The bump that forms on your tibial tuberosity will not affect you later in life
- Surgery is not needed
>only needed if the bone fragments do not heal themselves; very rare.
>if surgery is needed it will not be done will the child is still growing because this can damage the growth plate