Epidemiology Osgood-Schlatter disease

Epidemiology Osgood-Schlatter disease

Osgood-Schlatter In 1903 Osgood (Osgood, 1903)1 and Schlatter (Schlatter, 1903)2 independently described a pain to the frontal side of the tibial tuberosity.
Sex The disorder is higher in boys than in girls, perhaps partly due to the fact that boys do more to these sports. 6,7
Age The Osgood-Schlatter disease occurs in children that are in growth aged 8 to 15 years old.4,5

Osgood-Schlatter disease occurs in boys between 12 and 15 and girls between 8 and 12 years.4,7

Pain location The disorder causes local pain, swelling and tenderness of the tibial tuberosity.3
Pain sensation / Symptoms In 20 percent of the cases, the disorder is bilaterally.8,9
History of injury The Osgood-Schlatter disease nowadays is globally defined as a traction apofysitis of the tibial tuberosity, caused by repetitive traction and chronic avulsion of the secondary ossification center of the tibial tuberosity.3

Osgood-Schlatter disease is considered to be “self-limiting”, spontaneous recovery usually occurs at relative rest. About the risk factors of this condition is, however, is still a lack of clarity.3

Clinical presentation It seems likely that children in the age 8 to 15 years, in growth and intense exercise, have an increased risk of developing Osgood-Schlatter’s disease. In this age group, the tibial tuberosity is located in the apophyseal stage “.6

At this stage, the cartilage of the tibial tuberosity is replaced for bone tissue. During this change, the tibial tuberosity isn’t able to absorb the forces of the ligamentum patellae.11 This idea is supported by research Demirag.12

 

Four stages in the development of the apophysis of the tibial tuberosity.
1. cartilaginous stage (age 0-11 years)
2. apophyseal stage (age 11-14 years)
3. epiphyseal stage (age 14-18 years)
4. bony stage (age> 18 years)

Literature
  1. Osgood, R.B. (1903) Lesions of the tibial tubercle occurring during adolescence. Boston Medical and surgical journal, 148, 114-7;
  2. Schlatter, C. (1903). Verletzungen des schnabelformigen fortsatzes der oberen tibiaepiphyse. Beitrage zur Klinischen Chirurgie, 38, 874-87;
  3. Purushottam, A., Gholve, Scher, M., Khakharia, S., Widmann, R.F. and Green, D.W. (2007). Osgood Schlatter syndrome. Current opinion in pediatrics, 19, 44-50;
  4. Blankstein, A., Cohen, I., Eim, M., Diamant, L., Salai, M., Chechick, A. and Ganel, A. (2001). Ultrasonography as a diagnostic modality in Osgood-Schlatter disease, a clinical study and review of the literature. Archives of orthopaedic and trauma surgery, 121, 536-9;
  5. Flowers, M.J. and Bhadreshwar, D.R. (1995). Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. Journal of pediatric orthopaedics, 15, 292-7;
  6. Ehrenborg, G. (1962). The Osgood-Schlatter lesion: a clinical study of 170 cases. Acta chirurgica scandinavica, 124, 89-105;
  7. Orava, S., Malinen, L., Karpakka, J. et al. (2000) Results of surgical treatment of unresolved Osgood-Schlatter lesion. Annales Chirurgiae et Gynaecologiae, 89, 298-302;
  8. Bloom, O.J. and Mackler, L. (2004) Clinical inquries. What is the best treatment for Osgood-Schlatter disease? The journal of family practice, 53, 153-6;
  9. Wall, E.J. (1998). Osgood-Schlatter disease: practical treatment for a self-limiting condition. The physician and sportsmedicine, 3(26).
  10. 1 Hirano, A., Fukubayashi, T., Ishii, T. and Ochiai, N. (2002). Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease. Skeletal Radiology, 31, 334-342;
  11. 11. Ogden, J.A. and Southwick, W.O. (1976) Osgood-Schlatter’s disease and tibial tuberosity development. Clinical orthopaedics and related research, 116, 180-9;
  12. 12. Demirag, B., Ozturk, C., Yazici Z. and Sarisozen, B. (2004). The pathophysiology of Osgood-Schlatter disease: a magnetic resonance investigation. Journal of pediatric orthopaedics, 13, 379-382;

 

 Physical Examination

The diagnosis osgood-schlatter is easy to establish if the patient reports pain at tuberoses tibiae and this is prominent. The symptoms are usually unilateral and present themselves after a period of overload of the adolescent skeleton and the ligament patellae.1 The symptoms disappear when the growth plate closes around the 17th year. 2
Literature
  1. Jackson, M.: ‘anterior knee pain’, the journal of bone & joint surgery 2001, 7:937-947
  2. Verhaar, Prof.dr. J.A.N., Linden van der, dr. A.J., Orthopedie, Houten/Diegem: Bohn Stafleu van Loghum, 2001

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