Osgood-Schlatter or Osgood-Schlatter disease is a relatively common aseptic (non-infectious) osteochondrosis of the tibial tubercle, which forms the patellar tendon insertion (tibial roughness) as a rough bony extension of the anterior tibial margin.
Due to the disturbed ossification it can also come in overloading the knee to detached ossicles (small bone segments), which can die off in the further course (osteonecrosis). As a result of the irritation of the patellar tendon, Osgood-Schlatter initially manifests as a result of movement and pressure-related pain in the region of the tibial roughness.
In addition, the disease can cause pronounced swelling, which leads to severe pain in tension over the patellar tendon. In the advanced stage, Osgood-Schlatter disease can cause protrusions in the affected knee area, some of which can be postponed.
The exact etiology of Osgood-Schlatter's disease is still unclear. It is believed that aseptic osteochondrosis is caused by an overload of the affected knee area.
Overload is caused by a discrepancy between exercise capacity and actual loading of the cartilaginous tuberosity of the tibial tubercle due to exercise-related micro injuries or obesity. The discrepancy, in turn, causes disturbed ossification of the cartilage nucleus as well as impaired fusion thereof with the adjacent tibial bone.
Also, the hormonal change during puberty may result in a reduced load capacity of the tibia (tibia) and thus an unevenly distributed load in the knee as well as an increased patellar tendon pull. In addition, it is assumed that local circulatory disorders can cause an Osgood Schlatter.
Osgood-Schlatter's disease is mainly caused by pain, especially under the kneecap and at the upper end of the tibia. These pains increase in addition to stress. The kneeling, the stretching of the leg, jerky kicking movements and so on are sometimes severely limited. Particularly affected are physically active children between the ages of 11 and 14 years.
It comes to a small curve, which eventually becomes visible. This is usually on the lower end of the kneecap and represents a swelling. If pressure is applied to them, it also comes to pain. The rounding can change very much. Rest breaks quickly make them smaller and go back inside again. Burdens - even short-term ones - make them swell again and become more sensitive.
Overall, the symptoms of Osgood-Schlatter are very specific. So it does not come to nocturnal pain or heat. The first pain in Osgood-Schlatter-Leiden is usually felt only indirectly by pressure on the patellar tendon. The other pain develops over a period of time and can remain very weak for a long time. The restrictions on stretching the knee joint are also an early symptom.
Characteristic symptoms such as stress-related pain and a pronounced sensitivity to pressure in typical knee areas are the first indications of Osgood-Schlatter's disease.
Ultrasound and X-ray examinations show that Osgood-Schlatter's tubercle tubercle tuberosity tuberosity tuberosity tuberosity tuberosity tuberosity can be detected by loosening bony structures as well as detached ossicles. In addition, the disease should be differentiated by an idiotial ligament syndrome (runner's knee).
If necessary, the diagnosis by ambiguous magnetic resonance imaging and / or scintigraphy, which simultaneously allows statements about possible metabolic disorders, is ensured in ambiguous cases. If an Osgood-Schlatter disease is diagnosed early and consistently treated, the disease generally has a good prognosis and almost always heals without consequences at the latest after completion of the growth phase.
In this disease sufferers suffer from bone problems in most cases. It comes to a very strong ossification, which has a very negative impact on the quality of life of the person affected. As a rule, especially children suffer, so that the growth and development of the child are significantly delayed by the disease. The disease can also have a very negative effect on adulthood and lead to complications.
The patients suffer from pain, which can occur mainly on the knees. Tightening the muscles is also painful in most cases, so children can not easily participate in sports. On the legs themselves, it also comes to severe pain, which can occur even without stress in the form of rest pain. In many cases, the regions are swollen or bruised.
The treatment of this disease occurs without complications with the help of physiotherapy. The complaints can be restricted. A shock wave therapy can also be used for healing. However, it can not be predicted whether a full healing will occur. However, the life expectancy of the patient is not reduced due to illness.
If the knee aches under load, especially during sports and when kneeling, a doctor should be contacted. Osgood-Schlatter must be diagnosed quickly so that treatment can be initiated before bone pieces come off the tibia. Strong pain in the area of the tibia indicates an advanced condition, which must be clarified immediately. Those affected talk best with the family doctor, who can make a first suspected diagnosis and, if necessary, other specialists. The symptoms usually occur between the ninth and fourteenth year of life.
Above all, adolescents and adult extreme athletes are affected. Those who belong to these risk groups should go immediately to the doctor with the symptoms mentioned. Osgood-Schlatter can be treated well if it is detected early. The patients should therefore contact the doctor at a first suspicion. In addition to the family doctor, sports physicians, orthopedists and physiotherapists can be consulted. Depending on the severity of the treatment, the treatment may be performed surgically or by pain medications and preventive measures such as sparing.
Since an Osgood-Schlatter disease is attributed to an overload, the therapeutic measures are primarily aimed at relieving the affected structures. For this purpose, in the early stages usually a burden of care by sparing, anti-inflammatory analgesics (anti-inflammatory drugs), cooling and physiotherapy is indicated.
Knee or kneecap straps can also help with pain relief. In addition, affected children and adolescents may be exempted from school sports. If more severe changes or a more advanced stage of disease are present, immobilization of the knee may be indicated by a gypsum plasterer restricting rotation of the knee joint. This gypsum tutor will be individually adapted to the affected knee to avoid pressure on the patella (kneecap) and potential slippage.
In some cases, forearm supports are also recommended for complete relief of the affected knee. As a support, locally applied ointments can be used. Similarly, a negative sales (lower sales) of the shoe sole contribute to the patellar relief. Recently, extracorporeal shockwave therapy has also been used to accelerate healing, although it has not yet been possible to clarify which factors are responsible for individual therapeutic success or failure.
In exceptional cases surgery may be indicated for detached ossicles such as sequesters (dead and demarcated bone tissue), joint (free joint) or bone dislocation, which irritate the ligaments and restrict the mobility of the knee joint. Surgical ossicle removal should only be performed after completion of the growth phase. Furthermore, weight loss should be sought in children affected by Osgood-Schlatter's disease, who also have obesity.
Since the underlying aetiology for Osgood-Schlatter disease has not been fully elucidated, there are no prophylactic measures related to the disease. Avoiding obesity and a one-sided load on the musculature supporting the knee joint, however, can prevent an Osgood Schlatter or minimize the discomfort.
In most cases, the affected person has only a few or even limited follow-up measures in the case of an Osgood-Schlatter. As this is a genetic disease, it usually can not be cured completely. Therefore, sufferers are usually always dependent on medical treatment by a doctor.
If the patient or the parent wishes to have children, a genetic test should be carried out primarily to prevent the recurrence of the disease. The treatment itself can be done by measures of physiotherapy or physiotherapy. The sufferer can do some of the exercises in his own home, which may speed up the treatment.
Many of those affected depend on the help and support of their own family in their everyday lives, whereby above all the care and the psychological support can have a positive effect on the further course of the illness. In general, a healthy lifestyle should be sought, and obesity should be avoided. In some cases, this disease reduces the life expectancy of the person affected.
Osgood-Schlatter offers a relatively good prognosis. The disease often disappears by itself. Many patients are free of symptoms after six to 18 months. In isolated cases, however, Osgood-Schlatter may develop into a chronic disease. In addition, a large proportion of patients suffer from persistent knee pain. If the pain persists for more than one to two years, a radiological examination is recommended. The doctor can make the diagnosis and give the patient a reliable prognosis.
The view at Osgood-Schlatter is good. Mild pain can be treated with medication. In addition, the disease progresses only slowly and does not significantly limit those affected in everyday life. The prognosis must be an orthopedist or an osteopath. For this purpose he will consult the results of the examination as well as insights from the interview with the patient.
Not least, the financial and social status of the patient also determines the prognosis. Costly therapy procedures are not always taken over by the health insurance companies. All these factors have to be included in the prognosis. Due to the lengthy course of the disease, the prognosis must be adjusted at regular intervals to the patient's state of health.
Osgood-Schlatter does not necessarily have to turn on a doctor. In case of mild discomfort, it is sufficient to protect the knee and to suspend no further stress for some time. The pain should go back a few days to weeks.
If the Osgood-Schlatter does not fade by itself, medical advice is needed. The physician will initially also recommend sparing the affected limb and also prescribe painkillers, anti-inflammatories and other medicines. Patients can relieve the pain by cooling the affected area regularly. Quark wrap and other home remedies may also be used in consultation with the doctor to reduce Osgood Schlatter.
If these measures have no effect, the doctor must be consulted again. Perhaps the Osgood-Schlatter is suffering a serious suffering. If the course is positive, sport may begin again after one to two weeks. Physiotherapy and massages contribute to a speedy recovery. Which therapy helps best, should be worked out with the orthopedist. If there are repeated complaints, possible causes should be identified and corrected. Often it is sufficient to warm up the muscles better before the sport or to wear other shoes.