Osgood-Schlatter disease is a common cause of knee pain in adolescents. It describes inflammation of the area just below the knee, where the kneecap tendon attaches to the shinbone.

Some doctors may refer to Osgood-Schlatter disease as osteochondrosis, tibial tubercle apophysitis, or traction apophysitis of the tibial tubercle. This condition describes a common cause of front knee pain in athletic children. It is particularly common in those who participate in running and jumping sports.

The name derives from American orthopedic surgeon Robert Bayley Osgood and Swiss surgeon Carl B. Schlatter.

In this article, we discuss Osgood-Schlatter disease, including symptoms, causes, and treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Osgood-Schlatter disease refers to a common cause of pain in the front of the knee. It typically occurs in late childhood and early adolescence and is most common in children ages 11–14 years old. This is typically due to growth spurts, when bones, muscles, tendons, and other structures change rapidly.

This injury is more common in males. It often occurs in children who are highly active, particularly in sports that involve running and jumping.

Repeated strain from running and jumping can result in an injury where the kneecap attaches to the shinbone. This causes injury to the growth plate in the tibia just under the kneecap that flares during activity and eases with rest.

With Osgood-Schlatter disease, a person typically experiences pain during physical activities, particularly running and jumping. It typically only affects one knee, though it can occur in both. The most common symptoms include:

  • pain and swelling just below the kneecap
  • a bony lump that is tender to touch
  • pain at the front of the knee during activity

The bones of children and adolescents include areas known as growth plates. These refer to areas of cartilage that are softer and more flexible than bone. They occur at the end of bones that help determine the future length and shape of mature bones. Long bones grow through the growth plates.

When a child is fully grown, these areas harden into solid bone. Before this point, these areas are weaker than surrounding structures, such as ligaments and tendons, making them more vulnerable to injury.

Some growth plates, such as those in the knee, serve as attachment sites for tendons. A bony lump known as the tibial tubercle covers the growth plate at the end of the shinbone, or tibia. The tendon from the kneecap, attaches to the tibial tubercle.

A doctor may refer to a site where a tendon attaches as an apophysis. This is why some people may refer to Osgood-Schlatter disease as tibial tubercle apophysitis.

The group of muscles in the front of the thigh, known as the quadriceps, attaches to the patella. When a person runs or jumps, the quadriceps pull on the patella, which puts tension on the patellar tendon. This, in turn, pulls on the tibial tubercle and the growth plate.

In some children, repetitive strain can lead to inflammation and tenderness in this area. Swelling may cause the lump to become more pronounced. Additionally, stress and strain on the growth plate may cause microfractures or re-orientation of the growth plate.

Sports that typically correlate with a higher incidence of Osgood-Schlatter disease include:

  • soccer or football
  • gymnastics
  • basketball
  • sprinting
  • volleyball

It is important to note that while adolescents who participate in sports are at a higher risk of developing Osgood-Schlatter disease, less active individuals can also experience this problem.

A medical history and a physical examination are typically sufficient for a doctor to diagnose Osgood-Schlatter disease. During the examination, a healthcare professional may apply pressure to the tibial tubercle, which will be tender or painful for a child with the condition.

Additionally, they might ask the child to walk, run, jump, or kneel to determine whether these movements exacerbate discomfort. They may also request X-rays to help confirm the diagnosis and rule out differential diagnoses.

The pain being in the tibial tuberosity also helps to distinguish Osgood-Schlatter disease from other conditions.

For example, Sinding-Larsen-Johansson syndrome is another cause of knee pain in athletic children. However, while both conditions occur due to trauma of the growth plate, Osgood-Schlatter occurs below the kneecap in the tibial tubercle, and Sinding-Larsen-Johansson occurs higher, in the inferior pole of the patella.

Treatment options for Osgood-Schlatter disease focus on reducing pain, discomfort, and swelling. They typically include rest, reducing activities, and a strength conditioning program.

Pain that results from Osgood-Schlatter disease almost always ends when an adolescent stops growing. However, even with treatment, some people may experience symptoms for 12–24 months.

Most symptoms disappear around age 14 years for females and age 16 years for males. In the meantime, a person may find the following strategies beneficial:

Additionally, a doctor may recommend stretching and strengthening exercises to help ease knee pain. Some individuals may also benefit from a knee support bandage or knee straps. Potential knee exercises may include:

  • quadriceps stretches
  • hamstring stretches
  • gastrocnemius stretches
  • straight leg raises
  • bridges

In most cases, surgery is not necessary. This is because the growth plate will eventually stop growing and fill with bone, which is stronger than cartilage and less prone to irritation.

In very rare cases, a doctor may suggest surgery if a person has bone fragments that did not heal or if there is an actual fracture. However, a surgeon will not perform surgery until a person has stopped growing.

Evidence highlights that the outlook for a person with Osgood-Schlatter disease is generally excellent. It is a self-limiting condition, meaning it often resolves without any treatment. While a person will likely retain a prominence under their knee, it will reduce as irritation and inflammation ease.

In rare cases, a person may continue to experience pain into adulthood. In such situations, a doctor can provide treatment to reduce symptoms.

Osgood-Schlatter disease describes a common cause of knee pain among adolescents. It often occurs in physically active people when repetitive running and jumping movements cause swelling below the kneecap, at the top of the shinbone.

The condition is often self-limiting, meaning symptoms resolve when a person stops growing. To help reduce symptoms, a doctor may advise a person to rest and reduce activities.