Osgood-Schlatter disease is caused by inflammation of the tibial tuberosity, the insertion point of the patellar tendon. It is a common cause of anterior knee pain in adolescents.
It typically occurs in patients aged 10-15 years and is more common in boys and in those involved in high-impact sports (e.g., athletics). Osgood-Schlatter disease is usually unilateral, but it can be bilateral.
Pathophysiology
Repetitive traction at the tibial tuberosity, for example from running and jumping, can cause microtrauma and inflammation at the tibial tubercle apophysis, the growth centre at the tibial tuberosity. This may be accompanied by bone fragmentation or the formation of small ossicles (small separate pieces of bone). As this heals, new bone formation can leave a visible bony prominence below the knee. Initially, this lump is tender due to inflammation, but it often becomes harder and less tender as the inflammation settles.
Presentation
Osgood-Schlatter disease presents with a gradual onset of symptoms. The two key features are:
- A hard and tender lump at the tibial tuberosity
- Anterior knee pain, exacerbated by physical activity, kneeling and resisted knee extension
Management
Initial management focuses on reducing the pain and inflammation, with:
- Activity modification
- Ice
- NSAIDS (ibuprofen) for symptomatic relief
Once symptoms settle, stretching and physiotherapy can be used to strengthen the joint and improve function.
Prognosis
Symptoms usually resolve over time. The patient is often left with a hard bony lump at the tibial tuberosity.
A rare complication is a full avulsion fracture, where the tibial tuberosity is separated from the rest of the tibia. This requires surgical intervention.
Last updated July 2026
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