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Q:
I'm 28 and was (recently) diagnosed with OS. I did notice the condition around age 12, but did nothing about it. I've always had the tender bump on my knee, but in the last couple of years I've been feeling some daily discomfort (due to increase in sports). Is there any hope after having the disease for 15 years that it will heal itself?
Answered by
Jack Farr M.D.
on March 20, 2002
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A:
It has already healed. The stress reaction of your tibial tubercle growth center healed when you completed growth. In some individuals, there is a residual ossicle at this site that remains painful. The first step is a plain lateral radiograph. If there is an ossicle, your surgeon may discuss removal. Otherwise, you may have the equivalent of patellar tendonitis at the tubercle attachment of the patellar tendon for which your knee expert can initially design a conservative treatment program.
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Q:
Do you always get the bump under your kneecap? I don't have a big one but I have one, I've had it 3 years now. Is it possible I will have to have surgery if it gets to my meniscus?
Answered by
Jack Farr M.D.
on March 20, 2002
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A:
The bump of Osgood Schlatter’s stress reaction is from traction of the patellar tendon on the tibial tubercle growth center. It is not involved with the meniscus. Typically, the bump persists, although some of the soft tissue swelling may subside with time.
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Q:
How do I know if I have Osgood-Schlatter's disease?
Answered by
Joshua Siegel M.D.
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A:
Osgood-Schlatter's disease is essentially what we call apophysitis of the tibial tubercle. This means that the tension on the growth plate in the kneecap tendon has caused pain directly over this bump in the front part of your upper leg. This generally occurs in active children and can carry on into adult life after the growth plates are closed if a free ossicle never fused to the bone because of repetitive injuries.
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Q:
I have Osgood-Schlatter's disease. What kind of medication can I take, what exercise can I do, and what are the remedies I can use to relieve my symptoms?
Answered by
Joshua Siegel M.D.
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A:
Medications generally include anti-inflammatory medications and local application of ice. Exercises are generally those that strengthen the quadriceps muscles and the hamstring muscles under controlled mechanisms. Any exercises or activities that cause pain should be avoided, until you are symptomatically better. Other remedies that can be used include physical therapy modalities such as phonophoresis or iontophoresis. This must be discussed with your health care professional.
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Q:
When I was l5, I developed Osgood-Schlatter's disease in my knee, but it went away after a while. Now I am 22, and I have begun to feel extreme tenderness of the same bump below my kneecap. I have had MRIs and X-rays, but doctors could not determine what was causing the pain. Is it possible for the disease to occur again?
Answered by
Joshua Siegel M.D.
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A:
Generally, the disease does not reoccur, however, small ossicles that may not have fused can occasionally cause this pain. Insertional tendonitis can mimic Osgood-Schlatter’s disease, and since the x-rays did not show any un-fused ossicles or pieces of bone, that may be the case. These two conditions are very similar and have similar treatment patterns and courses.
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Q:
I am 22 years old and never recovered from a bout of Osgood-Schlatter's disease, which started when I was l4. Six months ago I underwent a partial excision of the offending bone in the knee, however, I am still not ready to undertake any physical activities apart from light walking. What is the timetable for recovery for this type of surgery and the best form of rehabilitation?
Answered by
Joshua Siegel M.D.
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A:
The recovery is variable depending on the amount of patellar tendon that had to be detached to shell out the ossicle. If minimal tendon was taken down, the recovery is generally quick and activities may be resumed within a month to six weeks. However, if more patellar tendon was taken down, a larger healing response is needed, and the recovery period can be prolonged. Physical therapy, including modalities such as iontophoresis and phonophoresis, in addition to a good quadriceps and hamstring program, and icing as needed would be the best way to recover quickly from this particular surgery. Generally, six months is a relatively long time for recovery.
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Q:
I know that Osgood-Schlatter's disease is common in teenage males, but it can also occur in older individuals. Is it a concern for older people?
Answered by
Joshua Siegel M.D.
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A:
No. Osgood-Schlatter's disease is a disease of skeletal immaturity. It does not occur in older individuals, although unfused ossicles from Osgood-Schlatter's disease may become symptomatic in later life. It is of no greater concern in older people than in young people, although younger people should generally be given a much longer time with conservative therapy before excision of the offending ossicle.
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