Management

management

This is usually a self limiting condition and resolves with skeletal maturity (may persist for up to 2 years until the apophysis fuses) (1).

Treatment includes:

• conservative therapy
  • successful in most patients:
  • a decrease in physical activities (rather than cease sporting activity altogether)
    • a graded reduction in exercise duration, frequency, and intensity until pain is resolved or can be tolerated
    • when the pain is tolerable, a gradual increase in workload should be considered (can be adjusted according to pain), repeat this process as required
  • applying ice packs (10 -15 minutes, up to three times a day, including after exercise) and analgesic medications
  • physiotherapy - to ensure flexibility in hamstrings and quadriceps
• corticosteroid injections are not recommended (2)

Persistence of the condition may warrant a short period of immobilisation (1). Continued pain into adulthood despite these measures may require surgery e.g. surgical excision of the bony fragment and/or free cartilaginous material (2).

Majority of the patients return to full activity in two to three weeks. An infrapatellar strap can be used for symptomatic relief during activity (about six to eight weeks) (3).

Reference:

• (1) Smith JM, Bhimji SS. Osgood Schlatter Disease. [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018
• (2) Weiler R, Ingram M, Wolman R. 10-Minute Consultation. Osgood-Schlatter disease. BMJ. 2011;343:d4534.
• (3) Cassas KJ, Cassettari-Wayhs A. Childhood and adolescent sports-related overuse injuries. Am Fam Physician. 2006;73(6):1014-22