Osgood Schlatters disease

NewsBot · May 17, 2008

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Limited ankle dorsiflexion: a predisposing factor to Morbus Osgood Schlatter?
Sarčević Z.
Knee Surg Sports Traumatol Arthrosc. 2008 May 16. [Epub ahead of print]

Quadriceps femoris muscle contracts eccentrically during the stance phase of running till the beginning of propulsion when the knee reaches the highest level of flexion. Limited dorsiflexion in the ankle joint is associated with a compensatory increased knee flexion, tibial inversion, and foot pronation during the stance phase of running. Theoretically, these compensatory mechanisms might cause increased stress on the quadriceps femoris muscle attachment to the tuberositas tibia. This study is aimed at evaluating a possible relationship between limited dorsiflexion of the ankle and the occurrence of Morbus Osgood Schlatter (MOS) in sports-active children. Forty-five children, including 40 boys (mean age 13 years, range 11-14) and 5 girls (mean age 12 years, range 10-12) with the clinical diagnosis of MOS, were studied. Dorsiflexion angle (DFA) of less than 10 degrees was found in 37 boys, whereas 3 of them had a DFA of more than 10 degrees . All five girls had a DFA of less than 10 degrees . In conclusion, limited dorsiflexion of the ankle joint might be of significant importance for MOS. Further studies are warranted to evaluate the cause-effect relationship.
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Admin2 · May 17, 2008

Related thread:
Taping/Bracing Osgood-Schlatter's

NewsBot · Nov 13, 2010

Prevalence and Associated Factors of Osgood-Schlatter Syndrome in a Population-Based Sample of Brazilian Adolescents
Gildásio Lucas de Lucena, Cristiano dos Santos Gomes, Ricardo Oliveira Guerra
American Journal of Sports Medicine

Background: Osgood-Schlatter (OS) syndrome is a disease of the musculoskeletal system often observed during the bone growth phase in adolescents.

Hypothesis/Purpose: Demographic and anthropometric factors and those linked to the practice of sports may be related to the prevalence of OS. The aim of the present study was to describe the epidemiologic profile and associated factors of individuals with OS syndrome in a population-based sample of Brazilian adolescents.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: A cross-sectional study was conducted with 956 adolescent students (474 boys, 482 girls) from 2008 to 2009 enrolled in the school system of Natal, Brazil. The age ranged between 12 and 15 years (13.7 ± 1.04 years). Tests were performed to assess the anthropometric and clinical aspects related to OS. To confirm the diagnosis of OS syndrome, the participant had to fulfill all the following clinical criteria: pain with direct pressure on the tibial apophysis; aforementioned pain before, during, and after physical activities; enlargement or prominence of the tibial apophysis; pain with resisted knee extension; and pain from jumping.

Results: The prevalence of OS in the sample was 9.8% (11.0% of boys and 8.3% of girls; boys, 13.5 ± 1.07 years; girls, 13.6 ± 1.01 years). The results showed that 74.6% of the students suffered from muscle shortening. Multivariate analysis using logistic regression showed that the factors associated with the presence of OS were the regular practice of sport activity (odds ratio, 1.94; 95% confidence interval, 1.22-3.10) and the shortening of the rectus femoris muscle (odds ratio, 7.15; 95% confidence interval, 2.86-17.86).

Conclusions: The regular practice of sports in the pubertal phase and the shortening of the rectus femoris muscle were the main factors associated to the presence of OS syndrome in the students.
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JB1973 · Nov 13, 2010

"This study is aimed at evaluating a possible relationship between limited dorsiflexion of the ankle and the occurrence of Morbus Osgood Schlatter (MOS) in sports-active children."

What about less active children. The last two patients I have had that I thought may have osgood schlatters were very inactive ( and overweight). Does the lack of ankle joint dorsiflexion still matter in these guys? Or is the weight more of an issue.
Cheers
JB

Orthican · Sep 14, 2011

JB1973 said: ↑

"This study is aimed at evaluating a possible relationship between limited dorsiflexion of the ankle and the occurrence of Morbus Osgood Schlatter (MOS) in sports-active children."

What about less active children. The last two patients I have had that I thought may have osgood schlatters were very inactive ( and overweight). Does the lack of ankle joint dorsiflexion still matter in these guys? Or is the weight more of an issue.
Cheers
JB
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Hate to resurrect old topics but this one brings to light something my partner and I see quite a bit and is suggestive of a much larger problem overall. In my day to day practice I see a good many adolecents of both sexes and of many variable activity levels. Over the last ten years or so I heve noted an increase in problems such as this. We have noted that the causation of this problem in the high activity adolecent with a case of osgood is almost always the loss of active rom at BOTH the talocrural and knee from a tight triceps surae and tight quad mass. I very RARELY treat this with orthoses. Instead the resolution of symptoms without recurrence involves a good stretching routine.

In the inactive individuals the problem presents the same and the cause? Inactivity. Too much x box and computer with poor postural habits and over time guess what? ...weak muculature and quite tight as well. Again a good stretching routine will prevail as the most effective of the types of treatments for this problem.

I have treated the pronator with orthoses in the past for this and see the pronation as more of a red herring as opposed to the genesis of the problem. My reasons for this conclusion are that I have given osgood patients with pronation supports for it and monitored...I have given no support to pronators with osgood and given a stretching routine instead and monitored. Resolution was always achieved faster and with better results (no recurrence) than those who only wore support for the issue.

But keep in mind this was not anything more than my clinical subjective observation as opposed to any RCT.

The bigger problem? The computer age will give us quite a bit more of these sorts of problems as opposed to when mom sent them outside to play instead of them sitting down in front of a monitor or tv.

NewsBot · Sep 1, 2018

Pathogenic Factors Associated
With Osgood-Schlatter Disease
in Adolescent Male Soccer Players
A Prospective Cohort Study
Hiroyuki Watanabe et al
The Orthopaedic Journal of Sports Medicine, 6(8)

Background: A previous cross-sectional study reported that pathogenic factors associated with Osgood-Schlatter disease (OSD)
in adolescent athletes include increased quadriceps muscle tightness, lower leg malalignment, and development of apophysitis in
the tibial tuberosity.
Purpose: To confirm these pathogenic factors associated with OSD in a longitudinal study with regard to physical function and
performance.
Study Design: Cohort study; Level of evidence, 2.
Methods: In this study, 37 boys (mean age, 10.2 ± 0.4 years) were recruited from 2 soccer teams at an elementary school. This
cohort study was conducted over an observation period of 1 year, with measurements recorded at baseline, followed by screening
for OSD every 6 months. Variables evaluated at baseline included physical function (morphometry, joint flexibility, and lower
extremity alignment), presence of Sever disease, and kicking motion.
Results: Pathogenic factors associated with OSD in the support leg of adolescent male soccer players included height, weight,
body mass index, quadriceps femoris muscle tightness in the kicking and support legs, and gastrocnemius muscle tightness,
soleus muscle tightness, and medial longitudinal arch in the support leg. Additional factors included a diagnosis of Sever disease
and distance from the lateral malleolus of the support leg’s fibula to the center of gravity during kicking.
Conclusion: The onset of OSD was found to be affected by many factors, including developmental stage, physical attributes, and
pre-existing apophysitis. In particular, a diagnosis of Sever disease and backward shifting of the center of gravity during kicking
increased the risk of the subsequent onset of OSD, suggesting that these factors are very important as a possible focus for
interventions.
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NewsBot · Jun 14, 2019

Relationship Between Lower Limb Tightness and Practice Time Among Adolescent Baseball Players With Symptomatic Osgood-Schlatter Disease.
Omodaka T et al
Orthop J Sports Med. 2019 May 28;7(5):2325967119847978

BACKGROUND:
Osgood-Schlatter disease (OSD) is characterized by traction apophysitis of the tibial tuberosity. Few studies on symptomatic and asymptomatic OSD have correlated findings with clinical examination.

PURPOSE:
To investigate the relationship between lower limb tightness and practice time among adolescent baseball players with symptomatic OSD.

STUDY DESIGN:
Cross-sectional study; Level of evidence, 3.

METHODS:
The study participants were 402 male baseball players (N = 804 knees) with a mean ± SD age of 10.9 ± 1.5 years (range, 7-14 years). Participant age, height, body weight, body mass index, practice time per week, range of motion of the hip and ankle joints, heel-buttock distance (HBD), and straight-legged raise angle were evaluated. Tibial tuberosity development, as assessed with ultrasonography, was classified into 4 stages: cartilaginous, apophyseal, epiphyseal, and bony. Knees that were classified as apophyseal or epiphyseal were investigated. Participants were divided into 3 groups: non-OSD, asymptomatic OSD, and symptomatic OSD.

RESULTS:
Of 400 knees in the apophyseal and epiphyseal stages, 23 knees had asymptomatic OSD, and 11 had symptomatic OSD. Players with symptomatic OSD practiced for significantly longer than the non-OSD group (P = .001) and asymptomatic OSD group (P = .001). Players with symptomatic OSD also had a larger HBD (P = .006) and smaller range of motion regarding internal rotation of hip (P = .023) and dorsiflexion of the ankle (P = .013) than the non-OSD group.

CONCLUSION:
Players with symptomatic OSD had longer practice times than the non-OSD and asymptomatic OSD players. Symptomatic OSD was also associated with tightness of the lower limbs as assessed by the HBD and range of motion in the hip and ankle joints.
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NewsBot · Jul 30, 2019

The Passive Mechanical Properties of Muscles and Tendons in Children Affected by Osgood-Schlatter Disease
Enomoto, Shota et al
Journal of Pediatric Orthopaedics: July 23, 2019 - Volume Publish Ahead of Print - Issue - p

Background: Osgood-Schlatter disease (OSD) is a sports-related disorder involving apophysitis, which affects the tibial tuberosity. The identification of factors related to OSD is important for its prevention and early recovery from the disease. This study aimed to compare the passive mechanical properties of the muscle-tendon unit in children affected by an OSD and healthy children, by using ultrasound real-time tissue elastography.

Methods: Eighteen legs affected by OSD (OSD group) and 42 healthy legs (control: CON group) were assessed. The elasticity was obtained from the quadriceps muscles and patella tendon (PT) using real-time tissue elastography. The strain ratio (SR; muscle or tendon/reference ratio: strain rate of the muscle or tendon divided by that of the reference material) was calculated as an indicator of the elasticity of the tissue of interest.

Results: The SR of the PT in the OSD group was significantly lower than that in the CON group (P<0.05). We found no significant difference between the groups in terms of the SR value of all muscles (P>0.05).

Conclusions: The results suggest that a PT with a lower SR may be associated with an OSD and that the passive mechanical properties of the quadriceps muscles have limited association with an OSD.
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NewsBot · Aug 4, 2019

BJSM Podcast:
Osgood Schlatter – not the self-limiting condition we once thought. Episode

NewsBot · Jan 11, 2020

Editorial
Separating the myths from facts: time to take another look at Osgood Schlatter ‘disease’

NewsBot · Feb 2, 2020

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association
Daniel W. Green, MD, MS, FACS*, Sreetha Sidharthan, BS, Lindsay M. Schlichte, MS, ...
The American Journal of Sports Medicine January 31, 2020

Background:
Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tubercle caused by repetitive strain and chronic avulsion from the patellar tendon. No widely accepted anatomic risk factors have been associated with OSD.

Purpose:
To determine if OSD is associated with increased posterior tibial slope (PTS).

Study Design:
Cross-sectional study; Level of evidence, 3.

Methods:
Forty knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients 10 to 15 years of age with a clinical diagnosis of OSD and available lateral radiograph and magnetic resonance imaging (MRI) were eligible. Age- and sex-matched patients with a history of knee pain but no evidence of OSD on clinical examination and without significant pathology on lateral radiograph and MRI were included in the control group. PTS was defined as the angle between a reference line perpendicular to the proximal anatomic axis and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral radiographs by 2 blinded investigators. Interrater reliability of PTS measurements was evaluated using intraclass correlation coefficient (ICC). The independent samples t test was used to compare PTS between the OSD and control knees.

Results:
The mean age was 12.6 ± 1.6 years and 51% (37/72) of the knees were from male youth. There were no differences in age, sex, and laterality of knees between the OSD and control groups. The mean PTS was significantly higher in the OSD group (12.23°± 3.58°) compared with the control group (8.82°± 2.76°; P < .001). The ICC was 0.931 (95% CI, 0.890-0.957), indicating almost perfect interrater reliability.

Conclusion:
This study identifies an association between OSD and increased PTS. The clinical implications of this finding have not yet been elucidated. It may be speculated that in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS.
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NewsBot · May 4, 2020

Activity Modification and Knee Strengthening for Osgood-Schlatter Disease: A Prospective Cohort Study
Michael S. Rathleff, PhD, Lukasz Winiarski, MSc, Kasper Krommes, MSc, ...
Orthopaedic Journal of Sports Medicine April 6, 2020

Background:
Osgood-Schlatter disease (OSD) affects 1 in 10 adolescents. There is a lack of evidence-based interventions, and passive approaches (eg, rest and avoidance of painful activities) are often prescribed.

Purpose:
To investigate an intervention consisting of education on activity modification and knee-strengthening exercises designed for adolescents with OSD.

Study Design:
Case series; Level of evidence, 4.

Methods:
This study included 51 adolescents (51% female; age range, 10-14 years) with OSD. The 12-week intervention consisted of an activity ladder designed to manage patellar tendon loading and pain, knee-strengthening exercises, and a gradual return to sport. The primary outcome was the global reporting of change at 12 weeks, evaluated with a 7-point Likert scale (successful outcome was considered “much improved” or “improved”). Additional endpoints were at 4, 8, 26, and 52 weeks. Secondary outcomes included the Knee injury and Osteoarthritis Outcome Score (KOOS), objective strength, and jump performance.

Results:
Adolescents reported a mean pain duration of 21 months at enrollment. After 12 weeks, 80% reported a successful outcome, which increased to 90% at 12 months. At 12 weeks, 16% returned to playing sport, which increased to 69% at 12 months. The KOOS subscores of Pain, Activities of Daily Living, Sport and Recreation, and Quality of Life improved significantly (7-20 points), and there were improvements in knee extension strength (32%; P < .001), hip abduction strength (24%; P < .001), and jumping for distance (14%; P < .001) and height (19%; P < .001) at 12 weeks.

Conclusion:
An intervention consisting of activity modification, pain monitoring, progressive strengthening, and a return-to-sport paradigm was associated with improved self-reported outcomes, hip and knee muscle strength, and jumping performance. This approach may offer an alternative to passive approaches such as rest or wait-and-see, often prescribed for adolescents with OSD.
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NewsBot · May 5, 2020

IS OSGOOD-SCHLATTER DISEASE TRULY A BENIGN KNEE CONDITION? A PILOT STUDY DEMONSTRATING INCREASED POSTERIOR TIBIAL SLOPE
Daniel W. Green, MS, MD, Sreetha Sidharthan, BS, Lindsay M. Schlichte, MS
Orthopaedic Journal of Sports Medicine April 30, 2020

Background:
Osgood-Schlatter disease (OSD) is a traction apophysitis caused by repetitive strain and chronic avulsion of the secondary ossification center of the tibal tuberosity from the patellar tendon.

Purpose:
The aim of this study was to determine if OSD is associated with increased posterior tibial slope (PTS).

Methods:
A total of 40 knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients aged 10 to 15 years old with clinical diagnosis of OSD supported by radiographic findings on lateral X-ray and MRI were eligible. Age- and sex-matched subjects with history of anterior knee pain but no evidence of OSD on clinical exam and no fragmentation of the tibial tubercle on lateral X-Ray and MRI were included in the control group. PTS was defined as the angle between the reference line and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral X-Rays by two blinded investigators. Interrater reliability of posterior tibial slope measurements between the two examiners was evaluated using intraclass correlation coefficient (ICC). Independent-sample student t-test was used to compare PTS in the OSD and control knees.

Results:
Mean age at time of lateral radiograph was 12.6 ± 1.6 years and 51% (37/72) of knees were male. There were no differences in age, sex, and laterality of knees between the OSD and control groups. Mean PTS was significantly higher in the OSD group (12.23º ± 3.58º) compared to the control group (8.82 º ± 2.76 º, p<0.001) (Figure 1). ICC was 0.931 (95% confidence interval, 0.890 to 0.957) for measurement of PTS between the two examiners, indicating almost perfect interrater reliability.

Conclusion:
This study is the first to identify an association between OSD and increased PTS. The clinical implications of this novel finding have not yet been elucidated. However, several studies have demonstrated that increased PTS is a risk factor for ACL injury and re-tear. It may be speculated in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS.
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NewsBot · Jun 20, 2020

Current Management Strategies in Osgood Schlatter: A cross‐sectional mixed method study
K Lyng MS Rathleff BJF Dean S Kluzek S Holden
19 June 2020

Background
Osgood Schlatter (OS) is the most common knee condition in adolescent athletes aged 9‐16. Without evidence to guide clinical practice it is unclear how OS is managed. The aim of this study is to investigate how international healthcare professionals (General Practitioners, Physiotherapists, Rheumatologists, Sports and Exercise Medicine Doctors and Orthopaedic Surgeons) diagnose and manage OS.

Methods
This mixed‐method study used a convergent parallel design. A quantitative questionnaire and semi‐structured interview covered prognosis, diagnosis, treatment, and return to play of adolescents with OS. For quantitative data those who reported likely/very likely considered ‘for’ and unlikely/very unlikely ‘against’ (for specific diagnostic/management strategy). Qualitative data analysis used a phenomenological approach.

Results
Two hundred and fifty‐one healthcare professionals completed the questionnaire. The most common diagnostic criterion was pain at the tibial tuberosity (97% for). The most common treatments were patient education (99%) and exercise therapy (92%). Other treatments options were more heterogeneous, e.g. pain medication (31% for, and 34% against). Managing training load (97%), pain intensity (87%) and psychological factors (86%) were considered the most important factors influencing the return to activities. Several themes emerged from the interviews (on N=20) including imaging, pain management, family, psychosocial factors influencing prognosis.

Conclusion
Diagnosis criteria of OS was relatively well agreed upon, whereas triangulation of qualitative and quantitative data showed heterogeneity of treatments. Psychosocial factors including family were highlighted as critical in the management of OS.
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NewsBot · Jan 15, 2021

Osgood Schlatter disease associated with patellofemoral maltracking, chondrosis

NewsBot · Mar 15, 2021

A Systematic Review on Conservative Treatment Options for OSGOOD-Schlatter Disease
CorneliaNeuhaus et al
Physical Therapy in Sport; 9 March 2021

Highlights
•Osgood-Schlatter disease is a sport- and growth-associated knee pathology
•A relevant problem in young athletes predominantly treated conservatively
•Two randomised controlled trials exist, both investigated injection therapy
•No evidence exists on the effectiveness of exercise programs for these adolescents
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Objectives
Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with locally painful alterations around the tibial tuberosity apophysis. Up to 10% of adolescents are affected by OSD. Treatment is predominantly conservative. The aims of this systematic review are to comprehensively identify conservative treatment options for OSD, compare their effectiveness in selected outcomes, and describe potential research gaps.

Methods
A systematic literature search was conducted using CENTRAL, CINAHL, EMBASE, MEDLINE, and PEDro databases. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were searched. We also systematically retrieved review articles for extraction of treatment recommendations.

Results
Of 767 identified studies, thirteen were included, comprising only two randomised controlled trials (RCTs). The included studies were published from 1948 to 2019 and included 747 patients with 937 affected knees. Study quality was poor to moderate. In addition to the studies, 15 review articles were included, among which the most prevalent treatment recommendations were compiled.

Conclusion
Certain therapeutic approaches, such as stretching, have apparent efficacy, but no RCT comparing specific exercises with sham or usual-care treatment exists. Carefully controlled studies on well-described treatment approaches are needed to establish which conservative treatment options are most effective for patients with OSD.
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NewsBot · Mar 11, 2022

Osgood-Schlatter Disease in youth elite football: Minimal time-loss and no association with clinical and ultrasonographic factors
MohamedSchultzaJohannes L.TolbcdLindaVeltmandLisanneKaaden, van derdGustaafReurinkabce
Physical Therapy in Sport; 9 March 2022

Highlights
•Sever disease is strongly associated with the presence of Osgood-Schlatter Disease.
•Prevalence in elite youth football is 17%. 80% had no time-loss despite symptoms.
•Previous heel pain (Sever disease) may help to identify youth athletes at risk.
•Clinical and ultrasonographic factors had limited value identifying risk for OSD.
Click to expand...

Background
Osgood-Schlatter Disease is the most common cause of knee pain in youth. Scientific research in youth elite football is limited.

Objectives
To assess clinical and ultrasonographic factors associated with Osgood-Schlatter Disease and calculate point prevalence of clinical diagnosis and time-loss in youth elite male football.

Study design
Nested case-control study and cross-sectional prevalence study; Level of evidence: 3.

Methods
We obtained data during the pre-season periodic health evaluation. Osgood-Schlatter Disease diagnosis was defined as (1) athlete-reported anterior knee pain and (2) clinical confirmation by pain provocation at the tibial tuberosity. Time-loss was defined as inability to participate in team training and/or competition.

For the nested-case control study, we examined clinical and ultrasonographic factors in the U13 to U16 teams. We matched on calendar-age. The clinical factors were: self-reported history of Sever's disease, growth measures, leg muscles flexibility and strength and ultrasonographic bone maturity stages according to Ehrenborg, For the cross-sectional study, we included players of the U13 to U19 teams to calculate the point prevalence.

Results
The case-control study consisted 30 players and the cross-sectional study 127 players. Previous Sever's disease was strongly associated with Osgood-Schlatter Disease (OR = 16.8; p = 0.02; 95% CI = 1.6–174.5). None of the other clinical or ultrasonographic factors were associated. The point prevalence was 17% and 80% had no time-loss despite presence of clinical symptoms.

Conclusion
Considering the 16.8OR, previous Sever's disease indicates a strong association with Osgood-Schlatter Disease. Although generally suggested, growth velocity and bone maturity are not associated in an age-matched comparison.
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NewsBot · Jun 22, 2022

The Etiology and Risk Factors of Osgood–Schlatter Disease: A Systematic Review
Ludovico Lucenti et al
Children 2022, 9(6), 826; https://doi.org/10.3390/children9060826

The etiology and etiopathogenesis of Osgood–Schlatter Disease (OD) are not fully understood. The aim of this review is to systematically analyze the available literature about the etiology and risk factors of OD. The literature was systematically reviewed using the PRISMA criteria to evaluate all studies published in the last 25 years (between 1996 and 2021) dealing with the etiology of OD. A total of 16 articles were included. The etiology and risk factors of OD are controversial. The main articles focused on muscular factors (mainly tightness of the rectus femoris), alteration of the patellar tendon or extensor mechanism, mechanical factors (repetitive solicitation, trauma, sports), tibial anatomy (tibial slope or tibial torsion), and histological alteration. Associations with ankle kinematic and behavior disorders were also reported. Many theories about the etiology, risk factors, and associated factors of OD have been reported in the literature, but more studies are needed to fully understand the etiopathogenesis of this disorde
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NewsBot · Jun 23, 2022

Effect Of Fascial Distortion Model On
Osgoodschlatter Disease - A Case Study
Dr. Hiral Parmar, Dr. Sandip Parekh, Dr. Komal Chauhan
International Journal of Advanced Research and Publications

Background: Osgood-Schlatter disease refers to pain isolated to the bump just below the front of the knee in active, growing
children (usually aged 9-13 years).It is an inflammation of the bone, cartilage, and/or tendon at the top of the shinbone where the tendon
from the patella attaches. Repeated stress can cause the tendon to pull away from the shinbone a bit, resulting in the pain and swelling
associated with Osgood-Schlatter disease. Purpose: Aim of this study was to find out how treating distorted fascia improves ROM, Pain
and function of the patient.Case Description: We present a case of 13 year old boy who was involved in sport activity karate had difficulty
in performing karate and pain at anterior aspect of knee joint and also had difficulty in bending the knee Since 6 months. Orthopaedic doctor
advised him for rest and given medication But there was no improvement for long duration so doctor advised him for physiotherapy. we
started the treatment in form of ice pack application for 15 minutes and fascial distortion model techniques- trigger band technique and
continuum distortion technique was given for 3 weeks and 5 sessions per week. The pre and post measures of data taken every week.
Outcome Measures: Range of Motion, Visual Analogue scale, Wall Slide Test Conclusion: This study shows that FDM is effective in
reducing pain, improving ROM and physical function in case of Osgoodschlatter disease.
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NewsBot · Jun 28, 2022

The Etiology and Risk Factors of Osgood–Schlatter Disease: A Systematic Review
Ludovico Lucenti et al
Children 2022, 9(6), 826

The etiology and etiopathogenesis of Osgood–Schlatter Disease (OD) are not fully understood. The aim of this review is to systematically analyze the available literature about the etiology and risk factors of OD. The literature was systematically reviewed using the PRISMA criteria to evaluate all studies published in the last 25 years (between 1996 and 2021) dealing with the etiology of OD. A total of 16 articles were included. The etiology and risk factors of OD are controversial. The main articles focused on muscular factors (mainly tightness of the rectus femoris), alteration of the patellar tendon or extensor mechanism, mechanical factors (repetitive solicitation, trauma, sports), tibial anatomy (tibial slope or tibial torsion), and histological alteration. Associations with ankle kinematic and behavior disorders were also reported. Many theories about the etiology, risk factors, and associated factors of OD have been reported in the literature, but more studies are needed to fully understand the etiopathogenesis of this disorder
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NewsBot · Jun 30, 2022

Osgood-Schlatter Disease in youth elite football: Minimal time-loss and no association with clinical and ultrasonographic factors
MohamedSchultz et al
Physical Therapy in Sport; 55, May 2022, Pages 98-105

Highlights
•Sever disease is strongly associated with the presence of Osgood-Schlatter Disease.
•Prevalence in elite youth football is 17%. 80% had no time-loss despite symptoms.
•Previous heel pain (Sever disease) may help to identify youth athletes at risk.
•Clinical and ultrasonographic factors had limited value identifying risk for OSD.
Click to expand...

Background
Osgood-Schlatter Disease is the most common cause of knee pain in youth. Scientific research in youth elite football is limited.

Objectives
To assess clinical and ultrasonographic factors associated with Osgood-Schlatter Disease and calculate point prevalence of clinical diagnosis and time-loss in youth elite male football.

Study design
Nested case-control study and cross-sectional prevalence study; Level of evidence: 3.

Methods
We obtained data during the pre-season periodic health evaluation. Osgood-Schlatter Disease diagnosis was defined as (1) athlete-reported anterior knee pain and (2) clinical confirmation by pain provocation at the tibial tuberosity. Time-loss was defined as inability to participate in team training and/or competition.

For the nested-case control study, we examined clinical and ultrasonographic factors in the U13 to U16 teams. We matched on calendar-age. The clinical factors were: self-reported history of Sever's disease, growth measures, leg muscles flexibility and strength and ultrasonographic bone maturity stages according to Ehrenborg, For the cross-sectional study, we included players of the U13 to U19 teams to calculate the point prevalence.

Results
The case-control study consisted 30 players and the cross-sectional study 127 players. Previous Sever's disease was strongly associated with Osgood-Schlatter Disease (OR = 16.8; p = 0.02; 95% CI = 1.6–174.5). None of the other clinical or ultrasonographic factors were associated. The point prevalence was 17% and 80% had no time-loss despite presence of clinical symptoms.

Conclusion
Considering the 16.8OR, previous Sever's disease indicates a strong association with Osgood-Schlatter Disease. Although generally suggested, growth velocity and bone maturity are not associated in an age-matched comparison.
Click to expand...

NewsBot · Jul 20, 2023

Do adolescents with Osgood–Schlatter display nociplastic pain manifestations compared to controls: A cross-sectional study
Kristian Damgaard Lyng et al
May 31, 2023

Objectives
Osgood–Schlatter disease is an overuse musculoskeletal pain condition. The pain mechanism is considered nociceptive, but no studies have investigated nociplastic manifestations. This study investigated pain sensitivity and inhibition evaluated through exercise-induced hypoalgesia in adolescents with and without Osgood–Schlatter.
Design
Cross-sectional study.
Methods
Adolescents underwent a baseline assessment comprising clinical history, demographics, sports participation, and pain severity rated (0–10) during a 45-second anterior knee pain provocation test, consisting of an isometric single leg squat. Pressure pain thresholds were assessed bilaterally at the quadriceps, tibialis anterior muscle, and the patella tendon before and after a three-minute wall squat.
Results
Forty-nine adolescents (27 Osgood–Schlatter, 22 controls) were included. There were no differences in the exercise-induced hypoalgesia effect between Osgood–Schlatter and controls. Overall, an exercise-induced hypoalgesia effect was detected at the tendon only in both groups with a 48 kPa (95 % confidence interval 14 to 82) increase in pressure pain thresholds from before to after exercise. Controls had higher pressure pain thresholds at the patellar tendon (mean difference 184 kPa 95 % confidence interval 55 to 313), tibialis anterior (mean difference 139 kPa 95 % confidence interval 24 to 254), and rectus femoris (mean difference 149 kPa 95 % confidence interval 33 to 265). Higher anterior knee pain provocation severity was associated with lower exercise-induced hypoalgesia at the tendon (Pearson correlation = 0.48; p = 0.011) in participants with Osgood–Schlatter.
Conclusions
Adolescents with Osgood–Schlatter display increased pain sensitivity locally, proximally, and distally but similar endogenous pain modulation compared to healthy controls. Greater Osgood–Schlatter severity appears to be associated with less efficient pain inhibition during the exercise-induced hypoalgesia paradigm.
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NewsBot · Apr 30, 2024 at 5:59 AM

Self-management including exercise, education and activity modification compared to usual care for adolescents with Osgood-Schlatter (the SOGOOD trial): protocol of a randomized controlled superiority trial
Kasper Krommes, Kristian Thorborg, Mikkel Bek Clausen, Michael Skovdal Rathleff, Jens Lykkegaard Olesen, Thomas Kallemose & Per Hölmich
BMC Sports Science, Medicine and Rehabilitation volume 16, Article number: 89 (2024)

Background
Osgood-Schlatter is the most frequent growth-related injury affecting about 10% of physically active adolescents. It can cause long-term pain and limitations in sports and physical activity, with potential sequela well into adulthood. The management of Osgood-Schlatter is very heterogeneous. Recent systematic reviews have found low level evidence for surgical intervention and injection therapies, and an absence of studies on conservative management. Recently, a novel self-management approach with exercise, education, and activity modification, demonstrated favorable outcomes for adolescents with patellofemoral pain and Osgood-Schlatter in prospective cohort studies.

Aim
The aim of this trial is to assess the effectiveness of the novel self-management approach compared to usual care in improving self-reported knee-related function in sport (measured using the KOOS-child ‘Sport/play’ subscale) after a 5-month period.

Methods
This trial is a pragmatic, assessor-blinded, randomized controlled trial with a two-group parallel arm design, including participants aged 10–16 years diagnosed with Osgood-Schlatter. Participants will receive 3 months of treatment, consisting of either usual care or the self-management approach including exercise, education, and activity modification, followed by 2 months of self-management. Primary endpoint is the KOOS-child ‘Sport/play’ score at 5 months. This protocol details the planned methods and procedures.

Discussion
The novel approach has already shown promise in previous cohort studies. This trial will potentially provide much-needed level 1 evidence for the effectiveness of the self-management approach, representing a crucial step towards addressing the long-term pain and limitations associated with Osgood-Schlatter.
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