osgood schlatter
The reason for writing this article has to do with the fact that I already contracted this disease during my adolescence. Bearing in mind that it affects many teenagers who practice basketball, volleyball, gymnastics, athletics and football, it is important to understand what this disease is as well as its treatment.
Which is?
Osgood Schlatter's disease is one of the most common causes of knee pain in adolescent athletes. The onset coincides, in most cases, with growth spurts in adolescence between the ages of 10 to 15 years for men and 10 to 14 years for women. The condition is more common in men and occurs more often in athletes who practice sports that involve running and jumping. In adolescents aged 12 to 15 years, the prevalence of Osgood Schlatter's disease is 9.8% (11.4% in men, 8.3% in women). As for symptoms, these manifest bilaterally in 20% to 30% of patients.
The patellar tendon inserts into the tibial tubercle and consists of cartilaginous tissue. In the ages of 10 to 12 years in women and 12 to 14 years in men, ossification of the tibial tubercle occurs. It is during this phase of bone maturation that Osgood Schlatter's disease develops. Repeated traction on the tubercle leads to microvascular ruptures, fractures and inflammation, which then results in swelling, pain and tenderness.
This disease is an overuse injury. It occurs secondary to repetitive effort and microtrauma caused by the force applied by the patellar tendon at its insertion in the apophysis of the tibial tubercle. This force results in irritation and severe cases of partial avulsion of the tibial tubercle apophysis. The consequences of microtrauma include poor flexibility in the quadriceps and hamstrings as well as other evidence of misalignment of the extensor mechanism.
Disease assessment
Osgood Schlatter's disease is a clinical diagnosis and radiographic evaluation is generally not necessary. Plain radiographs can be used to rule out additional diagnoses, such as a fracture, infection, or bone tumor, if the presentation is severe. Classic radiographs of Osgood-Schlatter disease include an elevated tibial tubercle with soft tissue edema, fragmentation of the apophysis or calcification in the distal patellar tendon.
Treatment
Ultimately, it should be noted that the condition can persist for up to 2 years, until the apophysis fuses. Treatment includes relative rest and activity modification, according to the level of pain. There is no evidence to suggest that rest accelerates recovery, but restricting activities is effective in reducing pain. Patients can practice sports, as long as the pain disappears with rest and do not limit sports activities.
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Local application of ice can be used for pain relief, as well as a protective knee brace over the tibial tubercle to protect against direct trauma. Hamstring stretching and quadriceps stretching and strengthening exercises can be a useful addition, however, if pain does not respond to conservative measures, formal physical therapy can be considered!
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In severe prolonged cases, a short period of knee immobilization may be necessary. There is no evidence to recommend surgical intervention for Osgood-Schlatter disease, symptoms are usually self-limiting, with pain disappearing after the apophysis closes. Long-term sequelae may include a thicker tibial tubercle, but this is asymptomatic in the vast majority of cases.
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In about 10% of patients, symptoms can continue into adulthood. This long-term sequel occurs when the individual does not seek treatment or has poor adherence to the recommended treatment.