Osgood-Schlatter disease can be classified depending on the affected structures and progression:

1. Acute stress injuries: Arise from sudden or intense physical activities that cause overuse of the patellar tendon and its attachment to the shinbone.
2. Chronic overload: Develops from repeated mechanical stresses during the growth phase. Typical for adolescents who engage in intensive sports.
3. Unilateral manifestation: Affects only one knee, more common with less pronounced stress or asymmetric movement patterns.
4. Bilateral manifestation: Both knees are affected, usually in highly demanding sports or due to genetic predisposition.

The main cause of the disease lies in repeated mechanical overload during the growth phase:

• Mechanical load:
  • Repeated tensile stress by the patellar tendon at the insertion of the shinbone (tibial tuberosity), especially in sports such as soccer, basketball, or athletics.
• Growth-related factors:
  • Imbalance between bone growth and the adaptation of tendon and muscle structures.
• Risk factors:
  • Intensive sports activities during growth.
  • Genetic predisposition or familial clustering.

The symptoms of Osgood-Schlatter disease are characteristic and often occur unilaterally, but sometimes also bilaterally:

• Pain: Pain below the kneecap, especially during activities such as jumping, running, or climbing stairs.
• Swelling: Local swelling at the tibial tuberosity.
• Tenderness: Pain when palpating the affected area.
• Movement restrictions: Problems with extending or bending the knee in advanced stages.
• Bony protrusion: Visible or palpable thickening at the tibial tuberosity as a late consequence of the disease.

The diagnosis is based on a combination of medical history, clinical examination, and imaging techniques:

• Medical History:
  • The doctor inquires about typical symptoms, sports activities, and the duration of the complaints.
• Clinical Examination:
  • Palpation of the tendon insertion below the kneecap for tenderness and swelling.
  • Functional tests, e.g., extension of the knee under load.
• Imaging Techniques:
  • X-ray: Visualization of ossifications or fragmentations of the tibial tuberosity.
  • MRI: More precise assessment of soft tissues and inflammations.

Conservative Therapy

In most cases, non-surgical treatment is sufficient:

• Load Reduction:
  • Avoidance of sports activities or intense strain until the symptoms subside.
• Physiotherapy:
  • Exercises for stretching and strengthening the thigh muscles, especially the quadriceps.
• Medication Therapy:
  • NSAIDs (non-steroidal anti-inflammatory drugs) for pain relief and anti-inflammation.
• Cooling:
  • Application of ice packs to reduce swelling and pain.
• Knee Braces:
  • Relief of the affected area with special bandages or braces.

Surgical Therapy

Surgery is rarely necessary and is only performed in chronic cases with severe movement restrictions or persistent pain:

• Removal of Bone Fragments:
  • Surgical removal of detached bone pieces at the tendon insertion.
• Reconstruction:
  • Restoration of tendon insertions in severe changes.

To prevent or delay the disease, the following measures are recommended:

1. Adjusted athletic activity: Avoid excessive training intensity, especially during growth spurts.
2. Regular stretching: Exercises to improve the flexibility of the thigh muscles.
3. Strengthening the leg muscles: Promote knee joint stability through targeted training.
4. Wearing appropriate shoes: Use shock-absorbing sports shoes to reduce stress.
5. Early treatment: Seek medical advice early at the first signs of discomfort.