Osgood-Schlatter’s Condition

Osgood-Schlatter’s Condition (Tibial Tubercle Apophysitis)

This blog aims to explain the functional anatomy, clinical symptoms and treatment plan for patients presenting with this common growth related anterior knee pain. 

What is the tibial tubercle?

This is the bony lump at the top and front of the shin bone (tibia). It is where the kneecap (patellar) tendon attaches to the bone, which is the insertion point of the extensor mechanism of the knee. 

Pictures 1, 2 and 3 – Child’s knee

What is the extensor mechanism of the knee?

This comprises of the 4 quadriceps muscle of the thigh, the quads tendon above the knee cap (patella), the knee cap itself and the patellar tendon, which inserts into the tibial tubercle at the top end of the shin bone (tibia). As these muscles contract the knee straightens. (extends)

What is an apophysis? 

An apophysis is a skeletal growth area under a tension or pulling force. The largest apophysis in the lower leg is at the tibial tubercle. (see picture 4)

Picture 4 – Lateral X Ray of child’s knee with close up of tibial apophysis. Picture 5 – MRI scanner.

What is apophysitis? 

When the bony lump and its soft tissue covering becomes swollen and red this inflammation is termed apophysitis.
(see Picture 5)

Picture 6 – Child’s knee with location of tender spot.

Why does it happen?

The repetitive tension (pulling) force of the tendon inflames the growth area during activity particularly jumping sports, such as football and netball. This is particularly troublesome at times of skeletal bone growth (growth spurts).

Who gets it?

It affects active boys and girls at times of skeletal growth. This typically, but not exclusively, occurs between the ages of 8 and 12 years. It is fairly common, affecting approximately 1 in 5 children of this age.

What are the clinical symptoms and signs? 

It is characterised by pain and/or a tender lump at the front of the shin bone, just below the kneecap. (see picture 6)

The pain varies from person to person. Some have only mild pain while performing certain activities, especially running and jumping. For others, the pain is nearly constant and debilitating. It usually occurs in just one knee, but sometimes it develops in both knees. The discomfort can last from a few weeks to many months and may recur until your child has stopped growing. 

How is it diagnosed?

Osgood Schlatter’s condition is usually diagnosed clinically ie: after talking a history and examining the knee, however X-rays (see Picture 4) and occasionally MRI scans (see Picture 5) are used to rule out any other problems with the knee joint itself.

What is the treatment?

Treatment is always non-operative and involves a number of strategies:
 
1. Avoiding the specific activities that really aggravate the pain.
1. Education and reassurance that the pain experienced is not serious and that things improve after growth stops.
3. Simple anti-inflammatories (ibuprofen) and simple painkillers (paracetamol).
2. Ice packs applied (wrapped in a cover) when the area is inflamed, after sports. 
4. Physiotherapy and exercises to stretch out tight muscles and tendons.
5. Very occasionally we advise crutches or a walking plaster to allow a period of rest.

Patient Information Leaflet

Download Osgood Schaltters PIL

Contact Form

    Your Name*

    Contact Email*

    Contact Number*

    Your Enquiry*

    Human Verification

    Recent News

    Nev Was Invited To Speak On SkySports News

    Nev was invited to speak on skysports news about the recent surge in ACL injuries at the topflight of Womens football. Female footballers are up…

    Information for Families – Overriding 5th toe

    Nev Davies Reading Children’s Orthopaedic Unit What is an overriding 5th Toe? This uncommon condition is usually present at birth but can become more noticeable…

    Nev talking at the 2nd International Child and Adolescent Knee Congress

    Nev is delighted and honoured to have been invited to Talk at The 2nd International Child and Adolescent Knee Congress in Sheffield later this year….

    Testimonials

    I had a knee arthroscopy to removed and clean up damaged cartilage after 6 years of repeated injury and dislocation from playing sport. I had been putting off the idea of surgery, but it was a great decision to finally get it seen to. I couldn't be happier with the results so far, and in less time than expected. Running, squats and climbing stair caused pain, and a lot more cracking than a 22 year old's knee should have! Now 2 weeks after the op, and following the physio exercises given after the operations, I am driving and climbing/ descending stairs without a problem and on the road to a full recover and hoping to get back to regular exercise within the next few weeks.

    I came to see you approximately four years ago and talked through the pros and cons of having an ACL replacement following an ACL rupture in my right knee I suffered playing an ill- advised game of beach volley ball on holiday in Antigua. I went ahead with the operation which you successfully performed at the Dunedin Hospital in Reading, I got on with my rehab and I now just wanted to let you to know that I will be running the London Marathon in three weeks (and raising money for Whizz-Kidz a disability charity for young people.) This letter is just a belated thank you for enabling this to happen.

    Mr Davies is a fantastic surgeon he put in a half knee joint in my right knee I have no problem with it ever since the operation in August last year. I have no more pain in my knee at all. I would recommend him to anyone.

    Mr Nev Davies has a very pleasant manner and was easy to talk to. The service provided was efficient, quickly identified the problems I had and was able to recommend treatment close to where I live.

    Memberships

    • General Medical Council (GMC) Membership
    • Royal College of Surgeons of England (RCS(Eng.))
    • British Medical Association (BMA)
    • British Orthopaedic Association (BOA)
    • British Society of Children's Orthopaedic Surgery (BSCOS)
    • British Association of Surgery of the Knee (BASK)
    • AO European Trauma Group
    • British Orthopaedic Sports Trauma and Arthroscopy Association (BOSTAA)