Osgood–Schlatter disease (OSD) is an osteochondrosis or traction apophysitis of the tibial tubercle
OSD is common during the early adolescent growth spurt between 10 and 15 years of age, particularly in children who participate in sports that involve running and jumping. It is more common in males and may affect both knees.
Most cases resolve with supportive treatment including rest, ice and NSAID medications. Physiotherapy includes stretching and strengthening exercises for the quadriceps and hamstring muscles.
1878 Odilon Marc Lannelongue (1840-1911) discussed ‘les ostéites apophysaires pendant la croissance‘. This in depth review outlines the condition it’s predominance in adolescence; differentation from TB; and the long term benign nature of tibial tuberosity apophysitis
Le changement d’état des apophyses, leur transformation lente ou rapide, réclame pour se produire le concours d’une irritation physiologique active, poursuivant son but de substitution jusqu’à son dernier terme: l’ossification complète après croissance achevée. Sous cette influence, et pendant toute sa durée, se trouve constituée une véritable prédispositon, une sorte d’imminence morbide. Dès ce moment les apophyses peuvent subir primitivement les mêmes atteintes que celles qui frappent ailleurs le tissuosseux.
Much more common are the enlargements of the tubercle of the tibia which are often seen in young people much given to athletic games. They complain of aching pain at and about the part, especially during and after active exercise, and the tubercle may be felt enlarged and is often too warm. The pain often continues, more or less, for many months, and there may be enlargement of the bursa under the ligamentum patellae, and the tubercle may remain too prominent ; but common as are these cases, especially in our public schools, I have never known grave mischief ensue in any of them, and they get well of themselves. They may represent one of the least degrees of periostitis due to strain; the increase of the prominence of the bone is only just beyond that which may be deemed the normal limit for the attachment of vigorous muscles.
1903 Swiss surgeon Schlatter published “Verletzungen des schnabelförmigen Forsatzes der oberen Tibiaepiphyse” [Injuries of the beak-shaped appendage of the upper tibial epiphysis] with was termed ‘Schaltterschen Krankheit‘.
Schaltter observed 7 patients with separation of the anterior rostrate (beak) process from the upper tibia noting that ‘these injuries represent a clinically sharply delineated profile of the disease whose symptom complex is in most cases simple and easy to diagnose without the use of radiographs’
1903 The American orthopedist, Osgood, wrote about bone changes on the tibial tubercle with a review of 10 patients in his time as a roetgenologist at Boston Children’s Hospital. “Lesions of the tibial tubercle occurring during adolescence” published in the Boston Medical and Surgical Journal.
Osgood advised conservative management and that ‘complete immobilisation for 6-8 weeks uniformally brought about a return to practically normal function…even though the fragment is not completely restored to it’s normal position.’
- Apophysitis of the tibial tubercle
- Osteochondrosis of the tibial tuberosity
- Lannelongue’s disease
- Lannelongue-Osgood-Schlatter disease
- Lannelongue OM. Note sur les ostéites apophysaires pendant la croissance. Bulletins et mémoires de la société de chirurgie de paris. 1878. Tome IV pp162 and pp276
- Paget J. Studies of Old Case-books. Longmans, Green. 1891
- Osgood RB. Lesions of the tibial tubercle occurring during adolescence. Boston Med Surg J 1903;148:114-117 [Full Text]
- Schlatter C. Verletzungen des schnabelförmigen Forsatzes der oberen Tibiaepiphyse. Beitrage zur klinischen Chirurgie, 1903;38:874-87
- Nowinski RJ, Mehlman CT. Hyphenated history: Osgood-Schlatter disease. Am J Orthop (Belle Mead NJ). 1998 Aug;27(8):584-5. [PMID 9732084]