Osgood-Schlatter Disease (osteochondrosis, apophysitis of the tibial tubercle) is characterized by a stress injury to the growth plate of the leg just below the knee at the tibial tubercle, a prominence just below the kneecap. The tibial tubercle is the bony attachment on the large bone of the lower leg (tibia) for the big, powerful thigh muscle (quadriceps). The growth plate is an area of relative weakness, and injury to it occurs due to repetitive stress from vigorous exercise. It is usually a temporary condition that is uncommon after age 16 or when the growth is completed.
Osgood-Schlatter disease results from repetitive stress and injury to the tibial tubercle growth plate, which is still developing during adolescence. Repetitive stress and injury affects the development of the bony tubercle and causes pain and tenderness to contact.
Initial treatment consists of anti-inflammatory medications (ibuprofen) and ice to relieve pain, stretching exercises, and modification of activities. To control symptoms, kneeling, jumping, squatting, stair climbing, and running on the affected knee should be restricted as necessary to minimize symptoms. An infrapatellar strap, a brace just below the kneecap, may help relieve symptoms. Surgery is occasionally necessary after skeletal maturity if the ossicle (bony fragment) becomes painful. Surgery on adults focuses on removing the painful ossicle and repairing the patellar tendon to relieve symptoms.
X-rays of male adolescent knee. The arrows indicate open growth plates. The tibial tubercle is circled on the lateral view.
Frequent Signs and Symptoms
- A tender prominence (bump) on the tibial tubercle
- Pain with kneeling
- Pain with activity, especially straightening the leg against force (stair climbing, jumping, deep knee bends, or weight-lifting) or following an extended period of vigorous exercise in an adolescent. In more severe cases, pain occurs during less vigorous activity