REVIEW – September 2012

Osgood-Schlatter disease: character and management


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Osgood-Schlatter disease is a frequent condition affecting the knees of adolescents, which is connected with the shortening of the rectus femoris muscle (concentric contraction) during sport activity. Unilateral and bilateral involvement can occur depending on load distribution. Consulting and instructing of young active children can avoid development and progression of Osgood-Schlatter disease with undesirable complications. If symptoms of OS are present it is recommended to apply muscle stretching before and after sport activities, limitation of activity, bearing of the knee orthosis and the infrapatellar strap and use of orthotic shoe inserts if needed. A rehabilitation physician should be attended at least once. Patients with severe pain should attend 1-week training courses with restricted running, walking stairs, squatting and jumping until pain relief is achieved. For prevention of muscle athrophy, it is recommended to modify sports activity, preferring fi rst swimming, followed by aqua jogging, cycling and skiing. It is desirable to maintain the modified load in the amount which ensures prevention of muscle atrophy. This requires individual training and physiotherapist evaluation. In addition, it is recommended to use sports massage, analgesics, magnetotherapy and iontophoresis with dexametazone and lidocain. An inappropriate load or training may result in further disease progression with fragmentation of apophysis, which may need surgical intervention. Longterm decrease in the training load is needed to prevent muscle athrophy.

In evaluation of OS disease, timely checkup and consulting of adolescents with knee pain complaints by the orthopaedist or the traumatologist, the rheumatologist and the rehabilitation physician is important. This requires teamwork between the coach, the patient, the general practitioner and other specialists.