Osgood-Schlatter

This is a common condition which has a bad name. Osgood-Schlatter disease is a cause of knee pain in adolescents, more commonly in boys than girls. In the office, a patient will tell me that their knee hurts right here, while they are pointing to a bump on the front of their knee.


To better understand the cause and treatment of Osgood-Schlatter we need to review some basic anatomy of the knee, specifically, the extensor mechanism. Your quadricep muscles condense to a single tendon, the quadriceps tendon, which, attaches to the patella, which, is attached to the patella tendon, which, inserts onto the tibia at the tibial tubercle.

The tibial tubercle overlies a growth plate, which allows the tibia to widen with growth. The growth plate is naturally a little weaker then the bone around it, since it contains cartilage and immature bone cells.

Osgood-Schlatter Disease is a traction induced inflammation of the tibial tubercle growth plate. That means that the pull of the extensor mechanism (the patella tendon pulling on the tibial tubercle) causes the growth plate to become slightly injured and inflamed. The body will try to heal this injury by building bone around the injured site, while the traction injury keeps recurring. This cycle causes the formation of a bony bump at the tibial tubercle.

Adults, who do not have growth plates, do not get Osgood-Schlatter. Instead, they get patella tendon tendinitis, which is called jumper’s knee. To prevent this from occurring, you will see basketball players being interviewed after a game with big bags of ice on their knees.

The most common physical findings are tenderness and a bump over the tibial tubercle. The patient will often also have some tightness of the quadricep muscles.

X-rays of the knee will often demonstrate some irregular calcification of the tibial tubercle. This x-ray finding is not needed to make the diagnosis though.

This is often a nagging problem. The patient may experience occasional episodes of pain for a few years. Sometimes, the pain may be bad enough to force the patient to limit their activities. The goal of treatment is to not only make the patient feel better now, but to prevent episodes of pain in the future.

The most important aspect of treatment is quadriceps stretching. Stretching these muscles will ultimately decrease some of the pull of the patella tendon onto the tibial tubercle, thereby, decreasing the potential inflammation of the growth plate. Stretching must be done every day as part of a routine and also before activities. It is also a good idea to place ice on the effected knee after activities to limit any inflammation which may develop.

Once knee pain has started, typical methods used to decrease inflammation are employed; rest, ice, compression (ace bandage), and inflammation relieving medicines, such as Motrin or Advil are used.

A patient with Osgood-Schlatter disease can participate in all activities up to their pain tolerance. Studies have shown that there is very little chance that a more significant injury to the knee can occur because of the Osgood-Schlatter disease.