How to cure Schlatter's disease. Schlatter's disease in the knee joint: treatment and rehabilitation. Return to sports

Osgood-Schlatter disease can present as a painful lump in the area below the kneecap during childhood and adolescence as puberty begins. Osgood-Schlatter disease occurs most often in children who participate in sports, especially sports such as running, jumping, or sports that require rapid changes in movement trajectories, such as football, basketball, figure skating and gymnastics.

And although Osgood-Schlatter disease is more common in boys, the gender gap narrows as girls become more involved in sports. Osgood-Schlatter disease affects more adolescents who play sports (by a ratio of one to five). The age range of incidence has a gender factor, as girls experience puberty earlier than boys. Osgood-Schlatter disease usually occurs in boys between 13 and 14 years of age and in girls between 11 and 12 years of age. The disease usually goes away on its own as bone growth stops.

General information

Osgood-Schlatter disease is a specific disease of the musculoskeletal system, namely the knee joints, characterized by dystrophic damage to the tibia in the area of its tuberosity. Such aseptic destruction of bone tissue occurs against the background of permanent or acute trauma and usually affects only young people at the stage of intensive skeletal development.
Clinically, the disease is manifested by swelling of the knee joint, the formation of a kind of growth (bump) under it and pain in its lower part, which occurs during normal physical activity (running, squats, etc.) or even without it.

This pathology was first described in 1878 by the French surgeon O. M. Lannelong under the name “Apophysitis of the tibia,” and in 1903, thanks to the work of the American orthopedist R. B. Osgood and similar works of the Swiss surgeon K. Schlatter (Schlatter), it appeared its more detailed nosography. Wikipedia defines this painful condition with the term “Osteochondropathy of the tibial tuberosity,” and the international classification assigned it the ICD-10 code – M92.5 “Juvenile osteochondrosis of the tibia and fibula.” Despite this, in medical practice this disease is still most often referred to as “Osgood-Schlatter disease” or simply “Schlatter disease”.

Schlatter's disease and military service

The conscription age in the Russian Federation applies to young people over 18 years of age. By this time, this pathology is in the stage of regression. And therefore it is not a reason for exemption from military service and conscription into the army.

A deferment is possible if there is a need to carry out a full course of treatment measures (usually it ranges from 6 to 12 months). The call is not carried out if Schlatter's disease has led to a functional impairment of the motor ability of the joint.

Pathogenesis

The mechanism of occurrence and further development of Osgood-Schlatter syndrome is directly related to the patient’s age and physical activity. According to statistics, in the vast majority of cases, doctors diagnose Schlatter's disease in children and adolescents in the age group from 10 to 18 years, while young people involved in sports suffer from it 5 times more often than their peers leading a passive lifestyle . The same reason for more intense physical activity explains the fact that this osteochondropathy mainly affects boys.

As is known, two large bones are involved in the formation of the human knee joint - the femur (above the knee) and the tibia (below the knee). In the upper part of the last of them there is a special area (tuberosity), to which the quadriceps femoris muscle is attached by means of a tendon. It is this part of the bone that is responsible for its growth in childhood and adolescence and is therefore particularly susceptible to various injuries and damage. During active physical activity, in some cases, the knee joint is subject to a large load and the quadriceps muscle is overstrained, which leads to stretching or tearing of the tendon and a lack of blood supply in this area. As a result of such a traumatic effect and a decrease in nutrition in the area of the tibial tuberosity, gradual necrotic changes develop in it, up to the death of individual parts of its core.

In addition, any injury to the knee joint or constant impact on its musculoskeletal structure (for example, jumping) can cause cracks and microfractures of the tibial tuberosity, which the growing body tries to quickly compensate for by the growth of new connective tissue. As a result of this, a person develops a bone growth (bump), typical of Osgood-Schlatter osteochondropathy, that forms just below the knee. Such a pathological process usually involves one leg, but bilateral involvement of the lower extremities is also possible.

The mechanism of occurrence of Schlatter's disease

This disease belongs to osteochondropathy - a group of pathologies that occur with various changes in the structure of cartilage and bones.

Frequent training leads to regular contraction of the quadriceps femoris and stretching of the patellar tendon. This causes trauma to insufficiently strengthened periarticular tissues.

Since the load does not stop, microtraumas and microtears do not have time to heal. As a result, the tibial tuberosity becomes an area of chronic injury and its blood supply is disrupted.

Due to insufficient nutrition, aseptic inflammation (non-purulent) occurs; the bone tissue at the site of damage is deformed, turning into a painful growth, and then gradually dies.

Since such microdamages do not appear overnight, the symptoms increase gradually:

at first the person feels slight pain when moving;
then, against the background of incessant loads, it intensifies, and a painful swelling appears on the lower leg.

Sometimes the pathology occurs in combination with tendonitis (inflammation of the patellar and quadriceps tendons), so pain is also felt along the tendon.

The disease can occur in waves - more acute periods are followed by complete recovery, and then the symptoms resume. But more often, more or less pronounced pain persists constantly, for a long time - from 12 to 24 months.

By the end of growth, all symptoms of Schlatter osteochondropathy disappear without a trace in 99% of cases without treatment. This usually happens between 17 and 20 years of age.

In adults, Schlatter's disease is diagnosed in 1% of cases. It is usually the result of ineffective treatment or complications of pathology during adolescence or young adulthood.

Classification

In the orthopedic environment, this pathology is usually classified according to the degree of its severity and the severity of the observed external and internal symptoms. Regarding this, there are three degrees of Schlatter’s disease, namely:

initial – visual manifestations in the form of a lump-like growth under the knee are absent or minimal, pain in the area of the knee joint is episodic, mild and occurs mainly at the time of physical activity on the leg;
an increase in symptoms - swelling of the soft tissues around the affected knee appears, a lump becomes visually visible directly below it, pain syndrome manifests itself during the period of loads on the leg and for a certain period of time after them;
chronic - a lump-like formation is clearly visible under the knee, which is most often surrounded by swelling, discomfort and pain in the joint is persistent and is observed even at rest.

How to treat Schlatter's disease at home

In some cases, Schlatter's disease can be treated at home, but only after an accurate diagnosis and visit to a doctor. These are mainly physical exercises and local therapy:

For constant and intense pain in the knee, in conjunction with medications, use compresses at night with non-steroidal topical drugs.
The use of folk remedies in the form of a variety of ointments, cold compresses based on chamomile, celandine, wax, honey, St. John's wort, knotweed, and yarrow is encouraged.
Massage with non-steroidal anti-inflammatory ointments for external use.
Therapeutic exercises alleviate the patient’s condition and prevent relapses of the disease. Do stretching exercises daily
The patient must remain calm and ensure a comfortable position of the affected joint;
During the rehabilitation period, completely limit physical activity on the sore leg.

Causes

There are two main physical activity-related underlying causes of Osgood-Schlatter disease in adolescents and children:

direct injuries to the tissues of the knee joint (subluxations and dislocations, sprains, bruises, fractures);
systematic microtraumas (external and internal) of the knee joint that occur as a result of intense sports or other activities associated with excessive physical stress on the lower extremities.

The greatest risk factors for Schlatter's disease in adolescents and children are:

football, basketball, handball, hockey, volleyball, tennis;
track and field athletics, acrobatics, gymnastics;
judo, kickboxing, sambo;
skiing, sports tourism, figure skating, cycling;
ballet, sports and ballroom dancing.

What could be the consequences?

Negative consequences of pathology are extremely rare. In the vast majority of cases, the disease is characterized by a benign course and independent regression after a person’s growth stops (23-25 years). It is then that the growth zones of the tubular bones close and, accordingly, the very substrate for the development of Osgood-Schlatter disease disappears. In some cases, an adult may be left with an external defect in the form of a tubercle under the knee, which does not in any way affect the function of the knee joint and the lower limb as a whole.

Consequence of Schlatter's disease in the form of a lump under the knee in an adult

But sometimes a complication such as fragmentation of the tuberosity can occur, that is, detachment of the sequestrum of the bone and separation of the patellar ligament from the tibia. In such cases, normal leg function can only be restored through surgery, during which the integrity of the ligament is restored.

Symptoms of Osgood-Schlatter disease

The severity of the negative manifestations of this pathology in different patients may differ depending on the nature of the injuries received, the degree of physical activity and the personal characteristics of the body.

At the beginning of the development of the disease, the patient begins to experience vague pain in the knee area, which usually appears after or during physical activity on the affected limb. As a rule, such pain is not yet associated with an internal pathological process and therefore there are quite few visits to the doctor during this period.

Over time, pain symptoms begin to increase, are localized in one place and can appear not only during physical activity, but also at rest. At the same time, swelling caused by edema appears around the affected knee, and a lump-like growth appears just below it. During this period of illness, it becomes increasingly difficult for the patient (especially the athlete) to perform his usual exercises, and sometimes even natural leg movements. The greatest intensity of pain is observed in the body position - kneeling.

Photo of a “bump” in Osgood-Schlatter disease

In addition, the patient may experience other negative symptoms:

tension in the leg muscles (mainly the thigh muscles);
limited mobility of the knee joint;
outbreaks of sharp “shooting” pain in the knee area, arising when it is overstrained;
severe morning swelling in the upper or lower part of the knee, which forms the day after physical activity.

When you independently palpate the affected knee, points of pain are felt, as well as smoothness of the contours of the tibia. The texture of the knee joint is felt as densely elastic, and a hard lump-like formation is felt under the swollen soft tissues. The general well-being of the patient, despite the accompanying pain and pathological processes in the knee, does not change significantly. The skin over the affected joint does not turn red, temperature indicators remain normal.

In most clinical cases, this disease occurs in a measured chronic form, but sometimes its wave-like course can be observed with periods of sudden exacerbation and relative calm. Without medical intervention and with continued physical activity, negative symptoms can persist for many months and worsen against the background of further mechanical damage to the knee joint. However, the manifestations of the disease gradually disappear on their own over 1-2 years, and by the time the period of bone tissue growth ends (approximately 17-19 years) they usually eliminate themselves. Before treating Osgood-Schlatter, the need for such therapy should be comprehensively and individually assessed, since in some cases it may be inappropriate.

What is Osgood-Schlatter disease of the knee?

For the first time, this type of pathology of the knee joint was systematized and described by the doctor Osgood Schlatter (or Osgood Schlatter) in 1906, after whom this disease was later named.

In addition, in the medical literature the disease can be found under other names:

Aseptic lesion of the tibia with localization in the epiphysis.
Osteochondropathy of the tuberosity of the tibia.

The pathological process develops gradually, initially affecting the cartilage tissue of the knee joint. This causes a protrusion (in the form of a lump) to form under the kneecap.

Over time, cartilage tissue degenerates into bone tissue, and as a result, the range of motion of the knee joint may be impaired.

Schlatter's disease of the knee joint

A detailed study of this disease allows us to establish that, in essence, it is a manifestation of osteochondrosis. In this regard, according to the international classification (ICD 10), it was assigned the digital code M92.5 (osteochondrosis in adolescence, localized on the tibia).

Tests and diagnostics

In general, the doctor can suspect the development of Schlatter’s disease due to the complexity of the patient’s clinical manifestations and the localization of the pathological process typical for this disease. The gender and age of the patient also play an important role in correct diagnosis, since adults, as a rule, are not exposed to this type of damage. Even through a simple visual examination and the usual collection of anamnesis regarding previous injuries or overloads of the knee joint, an experienced orthopedic traumatologist is able to make the correct diagnosis, but it would be useful to confirm it using some hardware diagnostic methods.

The decisive factor in making a definitive diagnosis of Osgood-Schlatter disease in children and adolescents has been and remains radiography, which, in order to increase the information content of the pathology course, is best carried out dynamically. To exclude other orthopedic diseases, such an examination of the affected knee joint must be carried out in two projections, namely lateral and direct.

In the initial phase of the development of the disease, X-ray images show a flattening of the tibial tuberosity in its soft part and a rise in the lower edge of the clearing, corresponding to the adipose tissue located in the anterior lobe of the knee joint. The last discrepancy with the norm is caused by an increase in the size of the infrapatellar bursa, which occurs as a result of its aseptic inflammation. There are most often no visible changes in the ossification nucleus itself at this stage of Schlatter’s disease.

As the pathology progresses, the x-ray picture changes for the worse. The photographs show a shift of the ossification nucleus by 2-5 mm upward and forward relative to the standard location of the tuberosity or its fragmentation. In some cases, there may be unevenness of the natural contours and unclear structure of the ossification nucleus, as well as signs of gradual resorption of its parts, but most often it fuses with the main body of the bone with the formation of a bone conglomerate in the form of a spiky protrusion. This “bump”, characteristic of Schlatter’s disease, in the later stages of the disease is especially clearly visible on a lateral radiograph and is clearly palpable during palpation in the area of the tuberosity.

In some atypical cases, an appointment may be necessary MRI, CT and/or Ultrasound problem knee and adjacent tissues, allowing you to clarify the expected diagnosis. It is also possible to use a technique such as densitometry, which will provide comprehensive data on the structural state of the bones being studied. Other laboratory diagnostic methods, including PCR studies and blood tests for rheumatoid factor and C-reactive protein, are carried out in order to exclude the possible infectious nature of problems with the knee joint (mainly nonspecific and specific arthritis).

Differential diagnosis of Osgood-Schlatter syndrome must be carried out with any fractures in the knee joint, tuberculosis of the bones, tendonitis patella, osteomyelitis, infrapatellar bursitis, Sinding-Larsen-Johanson disease and tumor neoplasms.

In order to make a diagnosis, the therapist only needs to examine and interview the patient. But in order to exclude the presence of complications or concomitant pathologies, the doctor prescribes additional diagnostic tests:

X-ray examination.

X-rays will allow you to take a clear picture of the fragmentation of the tibial tuberosity, as well as determine the exact size and location of the new bone formation.

Ultrasonography.

An ultrasound machine is not often used to diagnose Schlatter's disease. However, only ultrasound waves can show the echogenicity of the tumor. Seals usually indicate the presence of inflammation.

MRI and CT.

The results of these examinations are the most informative, but the procedures themselves are quite expensive and take a long time to complete. Therefore, if there is no suspicion of complications, an ultrasound or radiography is prescribed.

Treatment with folk remedies

With the permission of the attending physician and in addition to traditional methods of treating Schlatter's disease, the use of folk remedies is allowed, which mainly boil down to the use of various compresses and rubbing that relieve pain and inflammation. The following recipes have proven themselves well in this direction.

Honey compress

To make such a product, natural fresh honey should be mixed in equal proportions with medical alcohol and heated in a water bath until the honey is completely liquefied. Immediately after this, you need to moisten a clean piece of gauze in this mixture, apply it to the problem joint and wrap it first with cellophane and then with a warm cloth (preferably wool). Such procedures can be carried out twice a day for a month, keeping the compress on the knee for approximately 2 hours.

St. John's wort and yarrow

A kind of ointment is prepared from a crushed mixture of these herbs (in equal proportions), for which they are mixed with rendered pork fat, and then heated over low heat for 15 minutes. After cooling, the ointment is considered ready for use and can be rubbed into the skin around the injured knee 2-3 times a day.

Garlic

Two medium heads of garlic are peeled, passed through a garlic press and mixed with 400 ml of regular apple cider vinegar. Before use, this drug should be infused for a week in a dark glass container, where it can then be stored for six months. The method of application is to rub a small volume of this tincture into the damaged knee area 2-3 times a day.

Burdock

Finely chop a few fresh burdock leaves, place them on clean gauze and wrap it around the painful part of the leg for 3 hours. This dry compress is placed at night and applied once every 24 hours for one month (instead of burdock, you can take cabbage or plantain leaves).

Onion

Grate two small peeled onions on a fine grater and mix them with 1 tsp. granulated sugar. The resulting mixture is used for night compresses for about a month.

Healing oils

Camphor, clove, eucalyptus, menthol oil and aloe juice should be carefully mixed in equal proportions. This mixture should be rubbed into the skin over the damaged area several times a day, and then wrapped with a warm cloth.

Traditional healing recipes

As an additional treatment at home, after consultation with the doctor, you can use alternative medicine methods:

An infusion of dry comfrey and black root rhizomes is very suitable for a compress. To prepare the infusion, take 5 spoons of each ingredient, after which they are poured with boiling water and infused for 10-12 hours. The bandage with the compress should remain on the knee for no more than 8 hours.
Fir oil will help relieve pain, if used morning and evening.
Using sunflower seed oil or olive oil also allowed for compress.

Prevention

Prevention of the first occurrence or re-development of Schlatter's disease in general consists of controlling the intensity of physical activity performed by a child or adolescent on the lower extremities, especially if he is actively involved in sports, dancing, etc. This largely depends on the parents, since young people are rarely aware of the adequacy of their own training and can constantly overexert themselves. Also, an important role in the preservation of the joints and the entire skeletal system during the period of its growth is played by good nutrition, which should include the entire complex necessary for a developing organism. minerals And vitamins. In addition, it is imperative to undergo full professional treatment for any injuries sustained by children, even if at first glance they seem insignificant.

Surgery

Surgical treatment is indicated when the disease persistently progresses. The essence of the surgical intervention is to remove lesions that have undergone necrosis, as well as to stitch together an implant that secures the tuberosity of the tibia.

Surgical treatment of Schlatter's disease is advisable in the following cases:

with a long course of the disease (more than two years);
in the presence of complications (bone destruction or rupture of the patellar ligament);
if you are over 18 years of age at the time of diagnosis.

Surgical intervention is simple, but such interventions are characterized by a long recovery period, on which subsequent motor activity of the leg depends. For quick rehabilitation, you need to follow some rules:

after the operation, use a fixing bandage on the joint or use a knee brace for a month;
undergo a course of physiotherapy for rapid restoration of bone tissue (electrophoresis with calcium salts);
taking dietary supplements based on calcium and vitamin-mineral complexes (for six months);
avoid massive physical stress on the joint throughout the year.

Osgood-Schlatter disease in adults

The age group at increased risk of developing Schlatter's disease includes only children and adolescents, whose tibia in the area of their tuberosity are in the process of intensive growth. As it stops and the body naturally matures, the tuberosity zone becomes stronger and eventually completely ossifies, which in itself excludes the development of this disease in adults. The only thing that can connect adults with this osteochondropathy is its residual changes in the form of small tubercles under the knees.

Possible complications

Very rare but dangerous complications of osteochondropathy are:

patella displacement;
bone destruction (destruction of bone and cartilage tissue);
osteoarthritis of the knee (destruction of the articular surfaces).

If treatment is untimely or ineffective, they usually persist in adults.

Click on photo to enlarge

Complications and consequences of Osgood-Schlatter

Most often, Osgood-Schlatter disease does not lead to any serious complications in the damaged knee joint and goes away over time with virtually no consequences. Sometimes, at first after treatment, local swelling or minor pain persists in the knee area, which usually occurs after excessive physical exertion.

Also, quite often, in the area of the previously affected lower leg, a formed bone growth remains noticeable, which, as a rule, does not affect the mobility of the knee joint and does not cause a feeling of discomfort both in everyday life and during sports. In rare cases, with severe cases and/or improper treatment of Schlatter's disease, such a bone growth can provoke deformation and displacement of the patella. Patients with this complication in adulthood often suffer from knee osteoarthritis and may experience pain when kneeling, as well as aching pain when weather conditions change.

Characteristic symptoms

The disease begins with mild pain in the lower leg associated with strong movements of the leg. After stopping activity, the pain goes away. At this stage, the pathology does not worsen the patient’s quality of life or limit his ability to work.

Gradually, pain appears with normal movements such as walking.

After another workout, sometimes for no apparent reason, the pain intensifies to the point of being unbearable. A swollen, painful lump appears on the lower leg, noticeably protruding above the surface of the skin.

Edema on the lower leg due to Schlatter's disease

At this stage, any movement causes pain and limited mobility in a person.

The pain can be constant, of varying degrees of severity, with sudden attacks during exercise. Or it subsides completely for a certain period, and then resumes again.

In this case, the patient never has a fever or signs of general intoxication. There are also no local changes above the cone area.

In all adults who suffered from the disease in childhood, a protrusion is felt on the lower leg. Active movements in the joint are preserved in full. Some people are bothered by aching pain and aching in the knee when there is a sudden change in weather conditions.

Osteochondropathy often affects both legs.

List of sources

Abalmasova E.A. Osteochondropathies // Orthopedics and traumatology of childhood. - M., 1983. - P. 385-393.
Gorodnik A.G., Lantsov V.P. The problem of Osgood Schlatter's disease // Vestn. X-ray Radiol. - 1963.- No. 38.-С14-17.
Pozharsky V.F., Osteochondropathy of the tibial tuberosity (Osgood Schlatter disease) // Medical assistant Obstetrics.- 1982.- No. 47(9).- P.53.
Pudovnikov S.P., Tarabykin A.N. “Method of surgical intervention for Osgood-Schlatter disease” // Military Medical Journal 1987. - No. 7. - P. 62.
Esedov E.M. “Osgood-Schlatter syndrome” in the practice of a therapist // “Clinical Medicine”. - 1990, - No. 1. - P. 109-111.

Proper nutrition for Schlatter's disease

The basis of dietary nutrition for this disease is the consumption of foods with a high content of vitamins and calcium:

The daily diet should include vegetables rich in coarse fiber(cabbage, beets and pumpkin, bell peppers and tomatoes). Among fruits, you should give preference to apricots, citrus fruits, and persimmons.
Fermented milk products have a high calcium content(kefir, fermented baked milk and yogurt).
Try to avoid eating fatty meats, if possible, replacing them with lean beef, chicken, and seafood (sardines, flounder, tuna).

Pathogenesis of the disease

The quadriceps muscle is designed to extend the leg at the knee. It is located on the thigh, its lower part is attached to the kneecap (patella), which in turn is connected to the upper part of the tibia, where the ossification zone has not yet closed in adolescents. Excessive contraction of a poorly stretched quadriceps muscle leads to excessive stress on the patellar ligaments.

The tibia in adolescents is not fully formed and continues to grow. She is not strong enough for such loads. Therefore, inflammation and pain occur at the site of attachment of the ligaments to it. As a result of circulatory disorders, small hemorrhages appear. In more severe cases, separation of the upper epiphysis and aseptic (microbial-free) necrosis of the osteochondral areas occurs. Detachment of the periosteum may occur.

Pathogenesis of Schlatter's disease

The disease is characterized by alternating periods of death of small areas of tissue and their restoration. The necrosis zone is replaced by dense connective tissue. Gradually, a growth forms at the site of a long-term injury - a callus. Its value depends on the intensity and duration of the damaging effect. In the popliteal region, a thickened tuberosity is identified - a bump. It can be detected by palpating the lower leg, and if large, during examination.

Preventive actions

As with any disease, it is better to prevent Schlatter’s disease than to waste time and money on its treatment. To do this, you should pay attention to the following preventive rules:

if you send your child to professional sports, you are obliged to monitor his nutrition;
any sports training should be alternated with rest breaks;
in case of an injury of any severity, it is necessary to completely heal it in order to avoid unforeseen consequences;
If you experience pain of any kind, consult a doctor immediately4
try to avoid increased stress on the knee area.

Preventive measures will help avoid disease. But, if Schlatter’s disease has already occurred, then for a complete cure you should follow all medical prescriptions.

During the treatment process, it is advisable to avoid stress in the knee area, up to complete cessation of sports activities. After all, there is nothing more important than a healthy body.

Diagnostic methods

In the case of a typical course of pathology and the presence of characteristic external signs of osteochondropathy, diagnosis is not difficult. To do this, the specialist only needs to examine the patient and find out the characteristic complaints and risk factors for the disease.

X-rays are used to confirm the diagnosis. The photographs reveal an increase in the size of the tibial tuberosity and its heterogeneous structure. In the case of fragmentation, the images show the separation of a bone fragment with a visible fracture zone. In difficult to diagnose cases, they resort to magnetic resonance and computed tomography.

X-ray of a patient with Osgood-Schlatter disease

Another valuable diagnostic method is ultrasound. In this case, the ultrasound doctor can see an increase in the size of the tuberosity and its heterogeneous echostructure, as well as an increase in the size of the patellar ligament.

Differential diagnosis should be carried out with infrapatellar bursitis, cartilage or bone tumor, osteomyelitis, and handromalacia of the patella. The latter pathology is especially often disguised as Osgood-Schlatter disease in teenage girls, so below are criteria that will distinguish these two conditions.

If an adult is diagnosed with Osgood Schlatter disease, treatment includes simple remedies that can help manage the pain.

Treatment tips:

Get plenty of rest. It is necessary to allow the joint to rest - this is the most important thing that can be done in the situation of this disease. In addition, it is necessary to limit any load and not put any supporting weight on the joint during any movements.
Apply cold compresses. They will help reduce inflammation. The compress can be done three times a day for 10-15 minutes, repeating the procedure every day.
Massage. Massaging the quadriceps muscle is effective in stretching it and making it flexible enough to take on the everyday stresses placed on the joint. One method involves massaging the leg from the ankle up one side of the leg to the thigh and back down. Massage can be done 5 to 10 times a day.
Using knee pads. Applying a patellar tendon or knee brace can be a great help in treating the condition in adults. This is achieved by reducing muscle tension and supporting the knee joint. A knee brace helps absorb shock to the knee and change the angle of forces that affect the tendon. The knee brace can be worn whenever there is pain in the knee. You can try different types of knee pads to find the one that suits you best.
Taking medications. Your doctor will likely suggest nonsteroidal anti-inflammatory drugs, or NSAIDs, to reduce inflammation, such as ibuprofen. However, if the patient has asthma or heart problems, Ibuprofen is not allowed for use.
Use of external support. If a serious case of the disease is diagnosed, a cast may be needed to relieve pain. An x-ray will help determine damage to the bones of the joint.
Surgery. In extreme cases, surgical treatment of this disease in adults is possible. Sometimes a broken bone fragment can cause severe pain, in which case it will need to be operated on. One of the side effects of the surgery is a problem with blood circulation below the knee, but this problem is short-term and regular blood flow is restored quite quickly.

The long-term consequences of Osgood-Schlatter disease are usually minor. The disease stops when sports activity decreases or the growth spurt ends in children and when necessary measures are taken to protect the joint in adults.

In rare cases, a painful bone spur develops below the kneecap, which can be removed surgically. Surgical treatment of the disease is considered effective in eliminating its complications in adulthood.

How does the disease manifest?

During sports training you have to perform a lot of sudden movements. The result has the following consequences:

the tendon is greatly stretched;
microscopic tendon ruptures occur;
The tibia does not receive the necessary nutrition obtained from normal blood circulation. As a result, a growth appears.

In adolescents, the tubular bones connecting to the cartilage have growth zones and are able to stretch in length. Unlike bone tissue, cartilage does not have a very dense structure, so it is often injured during training. The site of injury begins to swell, pain and inflammation appear.

The body, trying to protect itself from injury, begins to independently restore the damaged growth zone, which leads to the formation of a growth at the site of edema.

Treatment methods

Treatment of Schlatter's disease of the knee joint is provided by several methods:

Regardless of the treatment prescribed for Schlatter’s disease of the knee joint, it is necessary to adhere to a certain lifestyle during the treatment and recovery period. Activities that cause pain should be avoided and stress on the knee area should be limited or removed.

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During periods when the disease worsens, you should not engage in intensive training. Swimming and gentle exercise on exercise bikes are allowed.

Symptoms

The symptoms of the disease are so specific and not expressed that initially the patient does not pay the slightest attention to the first “alarm bells”. He does not in any way associate the mild pain that periodically occurs in the knee joint with a previous knee injury. At first, pain begins to bother you when going up/down, bending your leg, squatting, and running. As the load on the knee increases - intense training and participation in sports - the symptoms of the disease begin to appear more clearly.

Previously, mildly disturbing pain in the lower part of the knee intensifies over time, becomes intolerable during movement, and subsides in a calm state. Sometimes a sharp, paroxysmal pain appears in the front of the knee joint - in the area where the patellar tendon attaches to the tibial tuberosity. A slight swelling of the knee joint becomes noticeable. However, the patient's general condition does not change - increased body temperature and redness of the skin are not typical for Schlatter's disease.

A visual examination of the knee allows us to draw conclusions about its swelling, due to which the contours of the tibial tuberosity are slightly smoothed. Palpation reveals the presence of a hard protrusion under the swelling, pain in the affected area and its swelling. The latter is characterized by a densely elastic consistency. During the process of bending/extending the knee, pain appears - and its intensity may vary.

Symptoms and degrees

The main symptom of Schlatter's disease is a specific neoplasm in the area of the tibial tuberosity in the form of a dense and immobile lump directly under the kneecap. The skin over the formation is unchanged, there are no signs of inflammation (redness, hyperthermia). In some cases, there may be slight swelling and tenderness when pressed.

The second sign is pain. The pain syndrome varies in intensity and occurs, as a rule, during physical activity and after physical exertion. With rest the pain goes away.

The function of the knee joint is not impaired unless there are complications. Tension and tenderness in the quadriceps femoris muscle are also detected.

There are 3 degrees of clinical course of the disease:

first - external signs of pathology are minimal or completely absent (no lump yet), but pain is observed;
second – characteristic external signs of the disease appear in the form of a lump under the knee, the pain becomes more intense;
third - the pathological process becomes chronic, accompanied by a constant feeling of discomfort, pain and external signs of osteochondropathy.

In the photo of the knee joint of a patient with Osgood-Schlatter disease, a specific lump is clearly visible - the main symptom of the pathology

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Causes of the disease

Doctors consider bruises and injuries to be the provocateur of Schlatter's disease. These include:

Displacement of articular surfaces;
complete or partial disruption of the integrity of the bone tissue in the knee;
rupture of the knee ligaments;
systematic microtraumatization possible during competitive activities.

Twenty percent of teenagers who are actively involved in sports suffer from this pathology. Only 5% of cases occur among unsportsmanlike children who do not play sports. That's what the statistics say.

Doctors have identified a number of sports games in which the risk of developing the pathology in question increases:

Hockey;
basketball;
football.

Teenagers involved in other sports also fall under the disease:

Figure skating;
gymnastics;
ballet.

Doctors believe that the disease progresses due to the following circumstances:

A fragile, young organism;
Heavy, prolonged physical activity;
Psychological pressure under the influence of competitive activity.

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How is the treatment carried out?

Conservative therapy

After the patient has undergone x-rays and other diagnostic methods that have confirmed the occurrence of Osgood-Schlatter disease, treatment begins. Its essence is to completely get rid of the inflammatory process, which is localized in the area of attachment of the patellar ligament. First of all, patients will need to give up physical activity for a while and follow a gentle daily routine.

Sometimes, if there is tibial tuberosity, you need to fix it using a special bandage. A tight bandage can also be used, with the help of which it is possible to reduce the amplitude of displacement. As for medications, they resort to the use of analgesics, painkillers and non-steroidal anti-inflammatory drugs. Osgood-Schlatter disease in adults will also need to be treated with vitamins B and E.

Physiotherapeutic methods

The method of physiotherapy prescribed by the doctor is directly related to the results of the x-ray. After receiving the answer, patients are divided into 3 groups:

First. Ultraviolet irradiation and magnetic therapy are used.
Second. Electrophoresis is used, during which lidocaine is used. After this, nicotinic acid and calcium chloride are prescribed, then magnetotherapy is prescribed.
Third. First of all, they resort to electrophoresis with aminophylline, after which potassium iodine is used. The final stage of physiotherapeutic treatment for this radiology group is magnetic therapy.

In addition, the following physiotherapy methods can be used:

phonophoresis,
laser therapy,
shock wave treatment.

Thanks to an integrated approach, during which drug treatment and physical therapy are used, it is possible to improve the patient’s condition and relieve him of pain. Moreover, it disappears not only at rest, but also during physical activity. However, therapy takes a fairly long period. Most often it lasts from 3 months to six months.

Is surgery necessary?

Surgical intervention is resorted to if conservative therapy lasts more than 2 years and does not bring the required effect. In addition, surgery is also prescribed when patients suffering from Osgood-Schlatter disease experience the following conditions:

severe pain that cannot be eliminated with medication,
fragmentation of the tibial tuberosity.

Doctors consider the operation quite easy. In its process, separated bone fragments are removed and plastic surgery of ligaments and tendons is performed. Mostly, the rehabilitation period after surgery takes a short time. The patient will need to wear a pressure bandage for a month. It is applied to the area of the tibial tuberosity.

The recovery period involves prescribing certain medications to the patient, as well as physical therapy. 14 days after the operation, pain in the knee, which is observed at rest, disappears from patients. As for disability, the period will take mainly 3 months. You are allowed to return to sports activity no earlier than six months after surgery to eliminate Schlatter's disease of the knee joint.

Treatment in Israel and Europe

Therapy for this pathology in medical clinics in Israel has a number of advantages, since the treatment process is based on the latest technologies, which make it possible to eliminate the symptoms of the disease in the shortest possible time.

In addition, unlike treatment centers in Germany or Italy, the cost of treatment is much lower.

The treatment process includes the use of the full scope of physiotherapeutic procedures, and if necessary, after 14 years of age, surgical intervention can be used, followed by a rehabilitation period.

Sports that can cause the development of Schlatter's disease

Further. Schlatter's disease occurs in almost twenty percent of adolescents who take part in sports competitions, while only a small part of them are not involved in active activities at all.

The disease can often manifest itself against the backdrop of hobby activities that require a lot of jumping, running and changing the trajectory of movement, for example:

football;
ballet;
basketball;
gymnastics;
volleyball;
figure skating.

How to relieve pain in the knee joint in a teenager with Schlatter's disease? More on this later.

Treatment

The disease can be easily cured; the main thing is to seek help in time and follow all the doctor’s recommendations.

Can I exercise during treatment? During the period of therapy and rehabilitation, you need to forget about sports, you need to avoid any overload of the joint. Treatment of Schlatter's disease will only be effective if you change your lifestyle. Therapeutic exercises and diet are required. It is necessary to take multivitamin complexes.

Schlatter's disease of the knee can be treated conservatively or surgically. The latter method is resorted to only when complications arise.

In children

Schlatter's disease in children and adolescents can resolve on its own without treatment. Therapy is needed only if complications develop:

transition of the disease to the chronic stage, when symptoms persist even after the end of skeletal growth;
the formation of a lump on the knee, which does not resolve and causes pain while walking;
significant swelling of the knee joint.

Therapy depends on the degree of development of Schlatter's disease. Treatment may be limited to the use of a bandage or elastic bandage to fix the knee. You may need to wear a brace to immobilize the limb.

For severe pain, it is necessary to use anti-inflammatory and analgesic ointments, for example, Diclofenac.

Physiotherapeutic procedures have a good effect in treating the disease:

ultrasound therapy;
laser therapy;
magnetic therapy;
electrophoresis;
thermal procedures - heating with paraffin, ozokerite;
hydromassage;
shock wave therapy;
massage.

The course of physiotherapeutic procedures is 3-6 months.

During the period of treatment, patients need to limit the load on the sore knee joint. You cannot run, jump, squat or kneel. Swimming is allowed in the pool.

The operation is contraindicated for children under 14 years of age.

In adults

Treatment of the disease in adults is similar to that for children. It is necessary to wear a bandage and attend physical therapy. If there is no effectiveness from conservative therapy, then surgery is indicated.

The operation is performed using an endoscope. In the postoperative period, the patient must wear a bandage, engage in exercise therapy and attend physiotherapeutic procedures.

Causes and predisposing factors

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Schlatter's disease in adolescents usually develops during a period of intensive growth (10-18 years). The peak incidence occurs at the age of 13-14 years in boys and 11-12 years in girls. The pathology is considered quite common and is observed, according to statistics, in 11% of all adolescents involved in active sports. The onset of the disease is most often observed after a sports injury, in some cases even minor.

There are three main risk factors for developing Osgood-Schlatter disease:

Age. The disease occurs mainly in children and adolescents; in older adults it is detected very rarely and only as residual effects in the form of a lump under the knee.
Floor. More often, osteochondropathy of the tibial tuberosity is observed in boys, but in Lately Due to the active involvement of girls in sports, these indicators are beginning to level out.
Sports activities. Schlatter's disease is five times more likely to affect children who are actively involved in various sports than those who lead a sedentary lifestyle. The most “dangerous” sports in this regard are football, basketball, volleyball, hockey, artistic gymnastics and dance sports, figure skating, and ballet.

To date, the true cause of the appearance of this form of osteochondropathy remains unknown. But many experts are inclined to believe that the formation of pathological bone growths is based on constant microtrauma (partial tears) of the tibial tuberosity due to increased load on the quadriceps muscle.

Risk factors include:

Age 10–15 years.
Male gender.
Rapid skeletal growth.
Engaging in active sports where running and jumping prevail.

According to statistics, approximately every second teenager suffering from Schlatter's disease has suffered a knee injury. Trigger factors in the development of Schlatter's disease can be direct injuries (damage to the ligaments of the knee joint, fractures of the tibia and patella, dislocations) and constant microtrauma of the knee during sports. Medical statistics indicate that Schlatter's disease occurs in almost 20% of adolescents who are actively involved in sports, and only in 5% of children who are not involved in sports.

Recent increased participation in sports sections girls has led to a narrowing of the gap between the sexes in terms of the development of Schlatter's disease.

Minor hemorrhages, rupture of patellar ligament fibers, aseptic inflammation in the bursa area, necrotic changes in the tibial tuberosity may be observed.

Osgood-Schlatter disease occurs in adolescents aged 10 to 18 years, mainly in boys during a period of intensive skeletal growth. Girls are less susceptible to this joint disease, which is due to the fact that they are less involved in sports like boys.

As you already understand, Osgood-Schlatter disease occurs during a period of intense bone growth under the influence of physical stress on the knees and thigh muscles. When playing sports such as football, basketball, hockey, gymnastics, etc., there is a strong load on the area of attachment of the ligaments to the tibial tuberosity, which causes injury, the development of an inflammatory process, the blood supply to this area is also disrupted with hemorrhages, and aseptic necrosis develops with detachments of tuberosity fragments.

This chronic course of Osgood-Schlatter disease leads to alternating processes of necrosis and regeneration, which is manifested by the formation of specific lumps under the kneecaps. This is a hypertrophied tuberosity of the tibia.

The disease mainly debuts at the age of puberty, and most often occurs in those children who are intensively involved in active sports.

Traditionally, boys play more sports, so they are more susceptible to Schlatter's disease, although today girls often suffer from this pathology. The disease occurs during the period of active skeletal traction and gradually stops as the bone skeleton grows.

Approximately 15-20% of adolescents who are actively involved in sports and participate in competitions have a similar disease. Among those who do not engage in professional sports, the percentage is lower - only 3-5% of those who are sick. Most often, Schlatter's disease occurs during jumping and traumatic sports.

When to see a doctor

You need to see a doctor:

if the knee is swollen or red;
if knee pain affects your ability to perform normal, daily activities;
if knee pain provokes fever, “locking” or “instability” of the knee joint.

When meeting with a doctor, it is important:

describe in detail the symptoms of the problems encountered;
talk about the child’s past physical problems;
talk about physical problems common in the child’s family;
tell about all medications and food additives taken by the child.

The doctor may ask some questions:

How severe is the leg pain?
Are there any noticeable swellings near the kneecap?
were there any injuries that could have caused the knee injury?
Is there pain before, during, or after exercise – or is it constant pain?
Was there any treatment at home? If so, did any of this help?
Have you had any problems with joint mobility or stability before?
What is your child's regular exercise or sports training regimen?
Have there been any recent changes to your child's training regimen or training methods?
Is the child able to tolerate the pain he experiences during sports at normal intensity?
Do the symptoms affect the ability to perform normal, daily tasks, such as walking up the stairs?

Questions to ask when visiting your doctor:

Is it possible to continue sports performances?
What signs or symptoms may indicate the need for a complete break from sports activities?
Do you need to make any changes to your sporting activity, such as changing your training or exercise plan, and if so, for how long?
What other measures can help in this situation?

What is the essence of the disease

The development of osteochondropathy in this localization is based on a discrepancy between the intensity of blood flow and the rate of bone tissue growth in the area of the apophysis of the tibia, which occurs at the age of 8-16 years. The fact is that the apophysis has separate blood vessels, which must provide this area with oxygen and all the necessary substances. This is a very important function, since it is due to the apophysis that the bone grows in length.

During the intensive growth of a child, the increase in bone mass occurs very quickly, and blood vessels cannot grow at such a rapid pace. As a result, part of the bone in the area of the tibial tuberosity experiences oxygen starvation and a deficiency of other substances necessary for normal development. The bone becomes very fragile and vulnerable to various kinds of negative influences, for example, microtrauma.

If during this period the body experiences physical overload (sports), due to constant microtrauma in the area of the patellar tendon, an aseptic type of inflammation develops in the thickness of the tibial tuberosity, its necrosis and fragmentation with possible separation of the ligament and dysfunction of the knee joint.

The disease has a chronic and long-term course (up to 2 years). As a rule, it is characterized by benign quality and resolves on its own without any consequences.

Conventionally, there are 4 stages of the pathological process:

Ischemia and necrosis of bone tissue.
Revascularization (ingrowth of new blood vessels into damaged bone).
Restoring the integrity of the tibial tuberosity.
The stage of closure of the apophysis and cessation of the disease (as a rule, completely occurs by the age of 21-23).

Diagnostic measures

As soon as signs of the disease become noticeable, you must contact an orthopedist for medical advice and treatment.

An X-ray examination is usually prescribed. The images are taken in two projections to obtain complete information about the disease. Using the images, the doctor examines the attachment points of the patella tendons to the area of the tibia.

In some cases, when X-rays are not enough for diagnosis, MRI, ultrasound or computed tomography are used.

Consequences

If you do not pay attention to the obvious signs preceding the disease, the following consequences may occur:

the mobility of the joint part will be impaired;
the tumor will begin to grow, taking on a spherical shape.

Do not delay or ignore medical advice. Even after surgery, you can return to active training in the second month.

Why is this dangerous?

In the absence of the correct influence, the disease develops into the form chronic type. The painful effect manifests itself constantly; after the child’s growth is complete, joint movement is limited, swelling appears immediately after heavy exertion.
The appearance of a large lump on the knee. Its dimensions may be different, but it practically does not interfere with movement. At the same time, if it does not resolve on its own (this happens quite often), then it will remain forever.
Against the background of increased articulation, inflammatory processes are formed (when soft tissues are damaged, purulent processes occur).

Surgical intervention

If the pathology continues to progress and conservative treatment does not bring any results, then surgical intervention cannot be avoided. Doctors perform an operation to mechanically remove the resulting tumor. If there is a need, they can even remove the entire area that was affected by the degenerative process. The diseased joint is replaced with a plastic implant. This method can be called radical, so it is used only after resorting to non-surgical methods of therapy.

The largest risk group is teenage boys from 8 to 18 years old who are actively involved in sports. According to statistics, 25% of children of a given gender and age experience Osgood-Schlatter disease in one form or another. And only 5% of them are not involved in active sports, but get sick due to various injuries or congenital defects of the knee cartilage.

Unfortunately, with the spread of women's sports, a unique risk group has formed among teenage girls. These are mostly girls from 12 to 18 years old, who are also actively involved in sports and receive sports injuries. Since the general vital activity of teenage girls is much lower than that of boys, the risk of the disease is lower - about 5-6%

The second significant risk group is professional athletes, usually young, who have suffered knee injuries of varying severity. Microtraumas in adulthood become the cause of disease much less frequently.

Clinically, the disease is manifested by swelling of the knee joint, the formation of a kind of growth (bump) under it and pain in its lower part, which occurs during normal physical activity (running, squats, etc.) or even without it.

Pathogenesis

Classification

initial – visual manifestations in the form of a lump-like growth under the knee are absent or minimal, pain in the area of the knee joint is episodic, mild and occurs mainly at the time of physical activity on the leg;
an increase in symptoms - swelling of the soft tissues around the affected knee appears, a lump becomes visually visible directly below it, pain syndrome manifests itself during the period of loads on the leg and for a certain period of time after them;
chronic - a lump-like formation is clearly visible under the knee, which is most often surrounded by swelling, discomfort and pain in the joint is persistent and is observed even at rest.

Causes

There are two main physical activity-related underlying causes of Osgood-Schlatter disease in adolescents and children:

direct injuries to the tissues of the knee joint (subluxations and dislocations, sprains, bruises, fractures);
systematic microtraumas (external and internal) of the knee joint that occur as a result of intense sports or other activities associated with excessive physical stress on the lower extremities.

The greatest risk factors for Schlatter's disease in adolescents and children are:

football, basketball, handball, hockey, volleyball, tennis;
track and field athletics, acrobatics, gymnastics;
judo, kickboxing, sambo;
skiing, sports tourism, figure skating, cycling;
ballet, sports and ballroom dancing.

Symptoms of Osgood-Schlatter disease

Photo of a “bump” in Osgood-Schlatter disease

In addition, the patient may experience other negative symptoms:

tension in the leg muscles (mainly the thigh muscles);
limited mobility of the knee joint;
outbreaks of sharp “shooting” pain in the knee area, arising when it is overstrained;
severe morning swelling in the upper or lower part of the knee, which forms the day after physical activity.

Tests and diagnostics

The decisive factor in making a definitive diagnosis of Osgood-Schlatter disease in children and adolescents has been and remains radiography , which, in order to increase the information content of the pathology course, is best carried out dynamically. To exclude other orthopedic diseases, such an examination of the affected knee joint must be carried out in two projections, namely lateral and direct.

In some atypical cases, an appointment may be necessary MRI , CT and/or Ultrasound problem knee and adjacent tissues, allowing you to clarify the expected diagnosis. It is also possible to use a technique such as densitometry , which will provide comprehensive data on the structural state of the bones being studied. Other laboratory diagnostic methods, including PCR studies and blood tests for rheumatoid factor and C-reactive protein, are carried out in order to exclude the possible infectious nature of problems with the knee joint (mainly nonspecific and specific).

Differential diagnosis of Osgood-Schlatter syndrome must be carried out with any fractures in the knee joint, tendonitis patella, infrapatellar , Sinding-Larsen-Johanson disease and tumor neoplasms.

Treatment of Schlatter's disease

During the natural maturation of the body and the cessation of bone growth, the pathological process in the knee joint disappears on its own, and therefore the advisability of treating Osgood-Schlatter disease in adolescents and children should be considered by a doctor on an individual basis, especially with regard to drug therapy and surgical intervention. In the vast majority of cases, this type of osteochondropathy can be treated conservatively on an outpatient basis using standard physiotherapeutic procedures and the involvement of minimum quantity medications.

First of all, treatment of Schlatter's disease of the knee joint in adolescents and children requires the patients themselves and their parents to fulfill the following mandatory conditions:

completely abandon physical activity on the lower extremities that preceded the onset of the disease (sports, dancing, etc.);
provide the injured leg (or two) with a gentle regimen that limits the mobility of the affected knee joint (move less unless absolutely necessary);
follow all other instructions of the attending physician (wearing a knee brace, applying compresses, following a diet, etc.).

With a mild course of the disease, treatment of Osgood-Schlatter can be limited only to local anti-inflammatory and analgesic medications (creams, ointments, etc.), as well as physiotherapeutic procedures. In case of severe pain, it can be relieved using drugs from the group NSAIDs . More serious injuries to the knee joint may require surgery (extremely rare).

The doctors

Medicines

If external medications are insufficiently effective, patients with osteochondropathy may be recommended oral medications from the group NSAIDs , having a similar effect and often including similar active ingredients -, etc.

As bone-strengthening therapy, calcium preparations (, etc.) are most often prescribed in combination with the group and.

In addition, some patients may be advised to apply various compresses (warming or cooling). In consultation with the attending physician, it is permissible to use traditional medicine recipes.

Procedures and operations

All physiotherapeutic and exercise therapy procedures indicated for Osgood-Schlatter disease are prescribed to the patient by the attending physician individually according to the general picture of the disease and are used in conjunction with drug treatment. Depending on the severity of the damage to the knee joint, the following techniques can be used.

Joint immobilization

If the functionality of the knee joint is seriously impaired, there is a need for external fixation, for which special knee pads or simply tight bandages are used. This measure significantly reduces the load on the knee, allowing previously damaged tissue to heal much faster.

Electrophoresis

Electrotherapy is practiced in virtually all cases of Schlatter's disease with the aim of relieving pain, as well as stimulating muscle activity in the problem area. Based on the degree of development of the pathology and its symptoms, solutions, drugs, etc. can be used in electrophoresis. One of the varieties of electrical procedures used in this case is high-tone therapy, with which you can achieve not only an analgesic effect, but also activate metabolic processes in joint tissues.

Magnetotherapy

Among the methods of modern physiotherapy, the effect of low-frequency magnetic fields on the affected area is considered one of the most effective in treating joint diseases. This method of therapy eliminates inflammation, relieves pain and accelerates the healing of injured tissue.

Shock wave therapy

Focused shock waves are used in the subacute period of osteochondropathy mainly to destroy existing saline calcium deposits , which allows you to restore normal blood supply to the pathological area and improve the penetration of necessary nutrients into it.

Laser therapy

It involves the use of low-intensity laser radiation on damaged joint tissue, which promotes maximum pain relief in the area and effective relief of inflammation. In addition, the biostimulating effect of the laser beam activates regeneration and accelerates healing processes.

Physiotherapy

After the acute symptoms of the disease have been eliminated, a course of special exercises is carried out, the purpose of which is to strengthen the tissue structures in and around the damaged joint. Particular attention is paid to strengthening the thigh muscles, which in the future reduces tension on the ligaments. In addition to physical therapy, massage courses are carried out using warming anti-inflammatory agents.

Thermal procedures

Physiotherapy for Schlatter's disease can be supplemented with thermal procedures, such as: infrared sauna , warming with paraffin, salt heating pads, ozokerite etc. They are often combined with local cryotherapy , which together have a beneficial effect on the blood supply to the problem joint.

The general course of drug and physiotherapeutic treatment of Osgood-Schlatter disease, as a rule, takes at least 3 months (sometimes up to six months) and ultimately leads to complete restoration of the function of the knee joint. At the same time, the lump underneath may persist, and active physical activity will most likely cause a resumption of the pathological process. It is for this reason that after treatment for this osteochondropathy, the patient is recommended to avoid excessive stress on the lower extremities for at least six months, including previous sports, dancing, etc.

Surgery

Surgical operations for Schlatter's disease are practiced extremely rarely and only with a combination of certain negative factors, which are:

long-term and constantly progressive course of the pathology;
serious damage to the knee joint with separation of several bone fragments from the tibial tuberosity;
ineffectiveness of all previously used conservative therapeutic methods.

In addition, surgical intervention is possible only when the child reaches the age of 14 years, with the exception of particularly severe and atypical clinical cases. The decision on the need for intra-articular surgery must be made by the doctor, taking into account all possible negative consequences, and the plan for such an intervention must combine maximum effectiveness and minimal trauma for the patient.

The choice of surgical treatment method is carried out individually for each individual patient, based on the severity of the damage to the knee joint observed in him. Basically, such operations are limited to the removal of displaced parts of the ossification nucleus, excision of necrotic foci, introduction of composite implants and/or suturing of a bone graft fixing the tuberosity.

In the postoperative period, the patient is prescribed drug therapy appropriate to the disease and a course of physiotherapy adequate to his condition, which should be aimed at relieving inflammation, pain and accelerating the fusion of bone tissue. For 3-4 weeks, the patient is required to wear a special pressure knee brace or bandage.

Treatment with folk remedies

Honey compress

St. John's wort and yarrow

Garlic

Burdock

Onion

Grate two small peeled onions on a fine grater and mix them with 1 tsp. granulated sugar. The resulting mixture is used for night compresses for about a month.

Healing oils

Prevention

Prevention of the first occurrence or re-development of Schlatter's disease in general consists of controlling the intensity of physical activity performed by a child or adolescent on the lower extremities, especially if he is actively involved in sports, dancing, etc. This largely depends on the parents, since young people are rarely aware of the adequacy of their own training and can constantly overexert themselves. Also, an important role in the preservation of the joints and the entire skeletal system during the period of its growth is played by good nutrition, which should include the entire complex necessary for a developing organism. minerals And . In addition, it is imperative to undergo full professional treatment for any injuries sustained by children, even if at first glance they seem insignificant.

Osgood-Schlatter disease in adults

Complications and consequences of Osgood-Schlatter

Also, quite often, in the area of the previously affected lower leg, a formed bone growth remains noticeable, which, as a rule, does not affect the mobility of the knee joint and does not cause a feeling of discomfort both in everyday life and during sports. In rare cases, with severe cases and/or improper treatment of Schlatter's disease, such a bone growth can provoke deformation and displacement of the patella. Patients with this complication in older age often suffer from knee pain and may experience pain when kneeling, as well as aching pain when weather conditions change.

Forecast

Since Osgood-Schlatter disease can be classified as an age-related pathology, which, with a mild course, often goes away on its own even without drug treatment, the prognosis for the patient’s absolute recovery is more than positive. However, this problem in a child should not be ignored under any circumstances, and if there is any suspicion of impaired functionality of the knee joint, it is necessary to consult an orthopedic doctor.

List of sources

Abalmasova E.A. Osteochondropathies // Orthopedics and traumatology of childhood. - M., 1983. - P. 385-393.
Gorodnik A.G., Lantsov V.P. The problem of Osgood Schlatter's disease // Vestn. X-ray Radiol. - 1963.- No. 38.-С14-17.
Pozharsky V.F., Osteochondropathy of the tibial tuberosity (Osgood Schlatter disease) // Medical assistant Obstetrics.- 1982.- No. 47(9).- P.53.
Pudovnikov S.P., Tarabykin A.N. “Method of surgical intervention for Osgood-Schlatter disease” // Military Medical Journal 1987. - No. 7. - P. 62.
Esedov E.M. "Osgood-Schlatter syndrome" in the practice of a therapist // "Clinical Medicine". - 1990, - No. 1. - P. 109-111.

Osgood-Schlatter disease most often manifests itself as a rather painful lump that is located below the kneecap. The disease manifests itself in adolescence and childhood (most often during puberty).

Most often it manifests itself in those children who lead a sports lifestyle, which require rapid changes in movement from a trajectory position (basketball, football), and often manifests itself in gymnasts and those who engage in figure skating. Jumping (of varying difficulty) and running can also cause the development of the disease.

Features of the disease

This is a pathological condition of the tibia, or rather its tuberosity, which is also called osteochondropathy. In adolescents, each tubular bone at the ends has peculiar cartilaginous additions, through which the bone becomes longer during the process of growth. At the same time, cartilage tissue is not so strong, which is why they can become wrinkled during jumping, heavy physical activity, or injury.

This action leads to the fact that this area becomes inflamed and swollen, and a serious manifestation of pain appears. The body, in turn, tries to restore the normal state of the zone, which leads to the appearance of a formation in the form of a bone lump.

Causes

Schlatter's disease is a rather unpleasant lesion that leads to a kind of deformation and also limits the mobility of the joint. The following factors lead to such consequences:

Too high, and a constant load on the knee. Microtraumas of the cartilage occur, which provokes the development of pathology.
Quite significant mobility of the joint. It may be due to the fact that the ligaments and surrounding muscles are quite weak.
Bone diseases, most often of an inflammatory nature. The point is that after certain injuries, if competent medical care is not provided, various pathologies develop, including improper fusion of elements. Against the background of all this, serious inflammation often occurs. Inflammation is also provoked by the fact that parts of destroyed cartilaginous tissue enter the articular space and the process of their decomposition begins.
Infectious lesions are combined not only with damage to cartilage tissue, but also with damage to soft tissue, which creates a favorable atmosphere for the development of Schlatter's disease against the background of a muscle infection.

Why is this dangerous?

In the absence of the correct influence, the disease develops into the form chronic type. The painful effect manifests itself constantly; after the child’s growth is complete, joint movement is limited, swelling appears immediately after heavy exertion.
The appearance of a large lump on the knee. Its dimensions may be different, but it practically does not interfere with movement. At the same time, if it does not resolve on its own (this happens quite often), then it will remain forever.
Against the background of increased articulation, inflammatory processes are formed (when soft tissues are damaged, purulent processes occur).

Symptoms

Symptoms may vary, but basically Schlatter’s disease manifests itself as follows:

An initially mild manifestation of swelling of the joint is subsequently formed.
When moving, the pain effect is quite strong, the same effect occurs when palpating the tibia.
Significant tension is felt throughout the entire limb, and in the affected area there is a feeling of some kind of tightening, heaviness in the muscles.
The movement of the joint has its own limitations; with active sports training, the pain will increase, and the ability to move will decrease.
Muscle wasting is possible; in this case, the knee joint becomes too mobile.

It should be noted that with the disease, symptoms may be less pronounced and manifest only minor discomfort. The intensity of symptoms will increase as the disease progresses. Pain directly depends on the tension and duration of impact on the joint.

Diagnostics

Visual inspection.
Assessment of sensations (study of symptoms).
Collection of data on all diseases and injuries of the limbs.
Radiography.
Ultrasound examination.
Computed tomography.

Treatment methods

Schlatter's disease is treatable in most cases.

Medication:

Taking painkillers with an effect on inflammation processes ( Tylenol, ibuprofen). The course of admission is insignificant.
Vitamin complexes (in particular vitamin B).

Physiotherapy:

Ultrasound therapy options are used, which allows immediately after the first dose to significantly reduce the manifestation of symptoms.
Magnetic therapy, in this case variants of a pulsed field are used, this effect provides relief from swelling and pain.

The method is also used therapeutic physical education. This method is used to stretch the quadriceps muscle and develop the hamstring tendons. This allows you to reduce stress and prevent injuries.

It is recommended to reduce physical activity and keep the joint at rest. If swelling occurs, cold can be applied. Specialized knee pads are also used to ensure reduced load on the joint.

Prevention

To prevent the occurrence of Schlatter's disease, you need to follow a number of rules:

If a child is actively involved in sports, it is necessary to ensure proper nutrition, as well as to ensure the alternation of training with rest.
If injuries occur, even minor ones, it is recommended to consult a doctor.
At the first manifestations of pathology, you should visit an orthopedist.
Reduce the load on the joint, consume vitamin and mineral complexes to generally strengthen the body.

Consequences and complications

The appearance of a lump that does not resolve, and to eliminate it, you will need to use surgery. In the absence of proper treatment of the disease, other pathologies may develop - arthritis, arthrosis, inflammation, etc.

This is an aseptic destruction of the tuberosity and nucleus of the tibia, which occurs against the background of their chronic injury during a period of intensive skeletal growth. It manifests itself as pain in the lower part of the knee joint, which occurs when bending it (squats, walking, running), and swelling in the area of the tibial tuberosity. Diagnosed based on an assessment of anamnesis, examination, X-ray and CT scan of the knee joint, local densitometry and laboratory tests. In most cases, it is treated with conservative methods: a gentle motor regimen, anti-inflammatory drugs, analgesics, physiotherapeutic agents, exercise therapy, massage.

General information

Schlatter's disease was described in 1906 by Osgood-Schlatter, whose name it bears. Another name for the disease, which is also used in clinical orthopedics and traumatology, reflects the essence of the processes occurring in Schlatter’s disease and sounds like “osteochondropathy of the tibial tuberosity.” From this name it is clear that Schlatter's disease, like Calve's disease, Thiemann's disease and Köhler's disease, belongs to the group of osteochondropathy - diseases of non-inflammatory origin, accompanied by necrosis of bone tissue.

Schlatter's disease is observed during the period of most intensive bone growth in children from 10 to 18 years old, much more often in boys. The disease can occur with damage to only one limb, but Schlatter's disease with a pathological process in both legs is quite common.

Causes

Trigger factors in the development of Schlatter's disease can be direct injuries (damage to the ligaments of the knee joint, fractures of the tibia and patella, dislocations) and constant microtrauma of the knee during sports. Medical statistics indicate that Schlatter's disease occurs in almost 20% of adolescents who are actively involved in sports, and only in 5% of children who are not involved in sports.

Sports with an increased risk of developing Schlatter's disease include basketball, hockey, volleyball, football, gymnastics, ballet, and figure skating. It is sports activities that explain the more frequent occurrence of Schlatter's disease in boys. The recent increase in girls' participation in sports has led to a narrowing of the gap between the sexes in terms of the development of Schlatter's disease.

Pathogenesis

As a result of overloads, frequent microtraumas of the knee and excessive tension of the patellar ligament, which occurs during contractions of the powerful quadriceps femoris muscle, a disorder of blood supply occurs in the area of the tibial tuberosity. Minor hemorrhages, rupture of patellar ligament fibers, aseptic inflammation in the bursa area, and necrotic changes in the tibial tuberosity may be observed.

Symptoms of Schlatter's disease

The pathology is characterized by a gradual, asymptomatic onset. Patients, as a rule, do not associate the occurrence of the disease with a knee injury. Schlatter's disease usually begins with the appearance of mild pain in the knee when bending, squatting, or going up or down stairs. After increased physical activity on the knee joint (intensive training, participation in competitions, jumping and squats in physical education classes), symptoms of the disease become manifest.

Significant pain occurs in the lower part of the knee, increasing when it is bent while running and walking and subsiding with complete rest. Acute attacks of cutting pain may appear, localized in the anterior region of the knee joint - in the area of attachment of the patellar tendon to the tibial tuberosity. Swelling of the knee joint is noted in the same area. Schlatter's disease is not accompanied by changes in the patient's general condition or local inflammatory symptoms such as fever and redness of the skin at the site of swelling.

When examining the knee, swelling is noted, smoothing the contours of the tibial tuberosity. Palpation in the area of the tuberosity reveals local soreness and swelling, which has a densely elastic consistency. A hard protrusion is palpated through the swelling. Active movements in the knee joint cause pain of varying intensity. Schlatter's disease has a chronic course, sometimes there is a wavy course with pronounced periods of exacerbation. The disease lasts from 1 to 2 years and often leads to recovery of the patient after the end of bone growth (at approximately the age of 17-19 years).

Diagnostics

Schlatter's disease can be diagnosed by a combination of clinical signs and typical localization of pathological changes. The age and gender of the patient are also taken into account. However, decisive in making a diagnosis is an X-ray examination, which should be carried out over time for greater information. X-rays of the knee joint are performed in direct and lateral projections.

In some cases, an ultrasound of the knee joint, MRI and CT of the joint are additionally performed. Densitometry is also used, which allows one to obtain data on the structure of bone tissue. Laboratory diagnostics are prescribed to exclude the infectious nature of damage to the knee joint (specific and nonspecific arthritis). It includes a clinical blood test, a blood test for C-reactive protein and rheumatoid factor, and PCR studies.

In the initial period, Schlatter's disease is characterized by a radiographic picture of flattening of the soft cover of the tibial tuberosity and raising of the lower border of the clearing, corresponding to the adipose tissue located in the anterior part of the knee joint. The latter is due to an increase in the volume of the subpatellar bursa as a result of its aseptic inflammation. There are no changes in the nuclei (or nucleus) of ossification of the tibial tuberosity at the onset of Schlatter's disease.

Over time, radiologically, a displacement of the ossification nuclei forward and upward by 2 to 5 mm is noted. The trabecular structure of the nuclei may be blurred and their contours uneven. Gradual resorption of displaced nuclei is possible. But more often they merge with the main part of the ossification nucleus to form a bone conglomerate, the base of which is the tibial tuberosity, and the apex is a spine-like protrusion, clearly visualized on a lateral radiograph and palpable in the area of the tuberosity.

Differential diagnosis of Schlatter's disease must be carried out with a fracture of the tibia, syphilis, tuberculosis, osteomyelitis, and tumor processes.

Treatment of Schlatter's disease

Physical therapy classes include a set of exercises aimed at stretching the hamstrings and quadriceps femoris muscles. Their result is a decrease in the tension of the patellar ligament, which attaches to the tibia. To stabilize the knee joint, the treatment complex also includes exercises that strengthen the thigh muscles. After a course of treatment for Schlatter's disease, it is necessary to limit the load on the knee joint. The patient should avoid jumping, running, kneeling, and squatting. It is better to change traumatic sports to more gentle ones, for example, swimming in a pool.

With severe destruction of bone tissue in the area of the head of the tibia, surgical treatment of Schlatter's disease is possible. The operation consists of removing necrotic foci and suturing a bone graft that fixes the tibial tuberosity.

Prognosis and prevention

Most survivors of Schlatter's disease retain a pineal protrusion of the tibial tuberosity, which does not cause pain or impair the function of the joint. However, complications can also be observed: upward displacement of the patella, deformations and osteoarthritis of the knee joint, leading to pain that constantly occurs when leaning on a bent knee. Sometimes after Schlatter's disease, patients complain of aching or aching pain in the knee joint that occurs when the weather changes. Prevention includes ensuring an adequate load regime on the joint.

Each tubular bone of a child, located in the arm or leg, has its own growth zones, which actively manifest themselves in the area of the end of the bones, consisting of cartilage.

This tissue is not strong enough like bone, and therefore is much more likely to be damaged and overloaded, which affects the growth zones, which can ultimately lead to swelling and general pain in this area.

During physical activity that involves prolonged running, jumping and bending, such as football, volleyball, basketball or ballet, children's hip muscles strain the tendons.

This puts tension on the quadriceps muscle, which connects the kneecap to the tibia. This is confirmed by reviews of Schlatter's disease of the knee joint in a teenager.

Such frequently repeated loads can lead to small tears of the tendons from the tibia, which will ultimately become a prerequisite for the appearance of swelling and pain, which is directly related to Schlatter’s disease.

In some situations, the child’s body attempts to close the described defect through the growth of bone tissue, which leads to the appearance of a bone lump.

The tibia is a tubular bone, the cartilaginous growth zones of which are located near the heads (epiphyses). In adolescents, these zones, due to the cartilaginous structure, are not as strong as in adults who have already stopped growing (their growth zones have already ossified), therefore they are more vulnerable to any injuries and excessive stress.

It is in this cartilaginous growth area that the tendon of one of the most powerful muscles of the human body, the quadriceps femoris, is attached to the tibia. This muscle contracts during running, jumping, walking, and performing other physical exercises involving the legs.

The main factor in the development of Schlatter's disease is damage to the knee joint as a result of intense physical activity. There are a number of reasons that cause such damage and provoke this disease:

The tibia is tubular and has cartilaginous formations at both ends that ensure the fusion of bone and muscle tissues with each other.

In an adult, in whom the growth process has already been completed, this bone and its components are very strong, and therefore resistant to external influences.

In the growing body of an active child, the knee joint, on the contrary, is still very fragile and is most susceptible to various types of injuries. This is why young athletes between the ages of 10 and 17 are more vulnerable to knee injuries.

This disease also has another name – Osgood-Schlatter disease. The main reason injuries to the knee joint can include dislocations, fractures and even ligament damage.

Approximately 20% of adolescents who have connected their lives with sports may experience Schlatter's disease, and only 5% of adolescent children who do not engage in sports.

It is the passion for sports such as hockey, gymnastics, volleyball, ballet, basketball, football and figure skating that have the greatest risk for developing the disease.

Sports that can cause the development of Schlatter's disease

Further. Schlatter's disease occurs in almost twenty percent of adolescents who take part in sports competitions, while only a small part of them are not involved in active activities at all.

The disease can often manifest itself against the backdrop of hobby activities that require a lot of jumping, running and changing the trajectory of movement, for example:

football;
ballet;
basketball;
gymnastics;
volleyball;
figure skating.

How to relieve pain in the knee joint in a teenager with Schlatter's disease? More on this later.

Symptoms and degrees

The main symptom of Schlatter's disease is a specific neoplasm in the area of the tibial tuberosity in the form of a dense and immobile lump directly under the kneecap.

The skin over the formation is unchanged, there are no signs of inflammation (redness, hyperthermia). In some cases, there may be slight swelling and tenderness when pressed.

Symptoms and degrees

The most common symptoms of this disease include the following disorders:

The main symptoms of Schlatter's disease are as follows:

Pain and swelling under the kneecap.
Pain in the knee joint during physical activity.
Tightness of the thigh muscles, pain along the tendon.

The intensity of pain is different for all children - it all depends on the individual threshold of pain sensitivity and the degree of damage to the cartilage tissue. The described symptoms also persist for varying amounts of time: in some patients for several weeks, in others for several months.

To prevent complications and start treatment on time, you need to know the main symptoms of Osgood-Schlatter disease in order to promptly seek help from specialists. If observed:

Then you definitely need to consult a doctor.

Sometimes Schlatter's disease in adolescents can take a chronic course, but most often there is an undulating course, which is characterized by lulls and periods of exacerbation.

Osgood Schlatter disease can last from one to two years and may go away after a teenager's bone growth has finished, which is around 17 to 19 years of age.

It is worth noting that this disease of the knee joint is not observed in adulthood.

How to diagnose the disease yourself?

First of all, you need to carefully listen to all the teenager’s complaints, and then examine the knee joint. It should be noted that Schlatter's disease usually affects only one leg.

When a child complains, take into account his physical activity and ask about the presence of injury. In addition, find out if there are the same problems before this condition.

If all the symptoms are similar to those listed above, then you should definitely seek help from a doctor who will examine the affected area, evaluate motor activity and order an x-ray of the lower leg, which will help to correctly diagnose and take the necessary measures for treatment.

The image may show a displacement of the ossification nuclei by 2–5 mm. In addition, there may be unclear trabecular structure of the nuclei or uneven contours.

Diagnostic methods

To diagnose Osgood-Schlatter disease, it is necessary to take an X-ray of the problem area. X-ray of the knee will help exclude benign and malignant tumors of other origins, sprains, bruises and other joint problems with similar symptoms.

Additional diagnostic methods include palpation of the tumor, patient complaints about severe pain with sudden bending of the knee.

Without proper treatment, Schlatter's disease leaves serious consequences in the form of bone lumps and growths under the knee.

To avoid consequences and for very pronounced symptoms, use the following treatments for Osgood-Schlatter disease:

Exercise therapy. Well physical therapy for those suffering from Osgood-Schlatter disease includes exercises aimed at strengthening the knee joint and developing hip muscles. A balanced cycle of stretching exercises for the hamstrings and quadriceps muscles will reduce the load on the problem area and will help improve the condition.
Massage the affected areas with warming and anti-inflammatory ointments. So, troxevasin ointment is ideal.
Physiotherapy. Tube ultraviolet irradiation is prescribed to patients with the last stage of the disease. If the changes are shallow, electrophoresis with calcium and novocaine, as well as heating, are prescribed.
Use of warm compresses.
Taking anti-inflammatory and painkillers. Ibuprofen and acetaminophen are commonly prescribed.

If the disease is detected in a timely manner, all doctor's instructions are carefully followed, and the conservative treatment methods described above are successfully applied, the disease goes away within a few months, and after about a year the patient returns to his normal lifestyle.

But if the disease progresses, and conservative methods are powerless, surgical intervention has to be used, namely mechanical removal of the tumor. If necessary, the entire area of the joint affected by the degenerative process is removed.

The “dead” joint is replaced with a plastic implant. Of course, such an intervention is a fairly serious step, and therefore non-surgical measures are used first.

As part of the diagnosis, the history of the disease is important. Therefore, the doctor may need the following information:

A thorough description of any symptoms and sensations the patient is experiencing.
Information about family health and family heredity.
The presence of a relationship between symptoms and physical activity.
Information about all medications and nutritional supplements that the child takes.
Information about the existence of medical ailments in the past, in particular in relation to any previous injuries.

A doctor (orthopedist or traumatologist) can diagnose the disease in question based on data obtained during a conversation with the patient (information about sports activities and complaints) and the results of the examination.

To confirm the diagnosis, additional studies may be required - x-rays of the knee joint and lower leg (allows you to assess the condition of the tibia at the site of attachment of the quadriceps tendon), ultrasound of the knee joint to exclude injuries or inflammatory diseases, blood tests (general clinical and rheumatic tests).

When diagnosing a disease, taking an anamnesis is of great importance. The combination of symptoms, the characteristic localization of pain, the age and gender of the patient allows us to accurately diagnose Schlatter’s disease.

However, the determining factor in making a diagnosis remains X-ray examination in frontal and lateral projection. Sometimes additional ultrasound of the knee joint, MRI and CT of the joint are performed, which must be carried out dynamically for greater information.

Densitometry is also prescribed to analyze the structure of bone tissue. Laboratory tests must be carried out in order to exclude infectious pathology (reactive arthritis).

For this purpose they prescribe:

general analysis blood;
blood test for C-reactive protein;
PCR studies (polymerase chain reaction);
blood test for rheumatoid factor.

In the initial stage of the disease, radiography demonstrates flattening of the soft cover of the tibia tuberosity. Over time, ossification may shift forward or upward.

The disease must be differentiated from tumor processes, tuberculosis, osteomyelitis, and tibia fractures.

In the case of a typical course of pathology and the presence of characteristic external signs of osteochondropathy, diagnosis is not difficult. To do this, the specialist only needs to examine the patient and find out the characteristic complaints and risk factors for the disease.

X-rays are used to confirm the diagnosis. The photographs reveal an increase in the size of the tibial tuberosity and its heterogeneous structure.

In the case of fragmentation, the images show the separation of a bone fragment with a visible fracture zone. In difficult to diagnose cases, they resort to magnetic resonance and computed tomography.

X-ray of a patient with Osgood-Schlatter disease

To establish an accurate diagnosis, a traumatologist or orthopedist conducts an initial survey and examination of the patient. The tests most often used are radiography of the knee joint (in several projections) and a clinical blood test (to detect inflammation).

Less commonly, if there are difficulties in making a diagnosis, the following diagnostic methods are used: ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI).

The most important thing at the diagnostic stage is to compare the pain, the general appearance of the damaged part of the lower leg and the results of studies with sports activities, as well as find out what injuries the child suffered previously.

Due to the complexity of diagnosis, it is necessary to take a responsible approach to choosing the attending physician.

Surgery

Usually this disease can be cured on its own, and its symptoms disappear immediately after bone growth stops. However, if the symptoms are severe, medication methods, physiotherapy and therapeutic physical education - exercise therapy should be included.

As part of the medical treatment of Schlatter's disease of the knee in a teenager, ointments and tablets are usually prescribed for painkillers such as acetaminophen, Tylenol and other drugs.

Another medication that may be suitable is ibuprofen. Physiotherapy makes it possible to reduce inflammation and relieve swelling along with pain.

Treatment of Schlatter's disease is carried out quite quickly and successfully. But to increase its effectiveness, the patient must be provided with peace.

Therefore, any physical stress on the legs is completely excluded; sports should remain a thing of the past. If after treatment the patient wants to resume sports activities, these will no longer be such active sports.

As for the treatment itself, it consists of several stages. Initially, drug treatment is carried out - it is aimed at eliminating pain and relieving inflammation.

If we talk about drugs, then medications from the NSAID series are used for these purposes. This is ibuprofen, Tylenol, any other analogues.

For severe symptoms, patients are advised to:

Peace.
Drug treatment.
Exercise therapy (physical therapy).
Physiotherapy.

Rest is a mandatory component of treatment. If the sore leg continues to be subjected to stress, pathological changes in the tibia will worsen.

Therefore, you should stop training completely for a while; in some cases, doctors even recommend changing your occupation to one that is less traumatic for the musculoskeletal system.

Until the acute symptoms subside, the knee joint must be made inactive by applying a fixing bandage.

Of the medications, the basis for the treatment of Schlatter osteochondropathy is painkillers, anti-inflammatory drugs (for example, ibuprofen). In addition, you can use various ointments, creams, and gels that have an analgesic effect.

Drug therapy must be prescribed by a doctor, since most anti-inflammatory drugs have side effects and numerous contraindications.

The duration of such treatment is determined individually, depending on the characteristics of the disease.

Treatment of Schlatter's disease is carried out by several specialists: traumatologist, orthopedist, surgeon. The disease is highly treatable, and symptoms disappear as the child grows older.

However, if the symptoms are significantly pronounced, then it is necessary to carry out symptomatic therapy that relieves pain and relieves swelling of the knee joint.

In order to relieve pain, it is necessary to completely eliminate physical activity and provide the greatest possible rest to the affected joint.

Treatment of Schlatter's disease is carried out according to the following scheme:

provide the patient with complete peace and comfort;
taking medications: painkillers, muscle relaxants and non-steroidal anti-inflammatory drugs;
physiotherapeutic methods;
physiotherapy.

The medicines used are:

painkillers;
non-steroidal anti-inflammatory drugs (analgin, diclofenac, ibuprofen);
muscle relaxants (mydocalm);
calcium supplements and vitamin D.

Medications should be given to a child with caution, only in short courses and in small doses. You can also apply cold compresses to reduce pain.

Physiotherapeutic methods are very effective because they can relieve inflammation and reduce pain. They improve blood circulation and nutrition of the tissues of the diseased joint, help restore bone structure, and reduce inflammation and discomfort.

These methods necessarily complement the treatment program:

magnetic therapy;
electrophoresis with various drugs (calcium chloride, potassium iodide, procaine);
shock wave therapy;
ultrasound therapy with glucocorticoids (hydrocortisone);
laser therapy;
paraffin compresses (with ozokerite, healing mud);
warming up the knee using infrared rays;
thalassotherapy (warm baths with sea salt or mineral water).

For each patient, the optimal treatment method is selected, which is determined by the doctor.

Physical therapy includes gentle exercises to stretch the quadriceps femoris muscle and develop the hamstrings. Such exercises reduce the load at the tendon attachment site to prevent tearing and injury.

During treatment, it is necessary to avoid physical activity and limit physical activity, which can increase pain.

In the acute period, intense physical activity should be replaced with more gentle physical therapy exercises, as well as swimming or cycling, but in a reasonable amount.

Surgical treatment of Schlatter's disease is advisable in the following cases:

In some cases, Schlatter's disease can be treated at home, but only after an accurate diagnosis and visit to a doctor. These are mainly physical exercises and local therapy:

Treatment of Schlatter's disease is not always necessary. If the pathology is not accompanied by a disturbance in the patient’s quality of life and is asymptomatic, then therapy is not prescribed.

In cases where the disease is accompanied by chronic pain or complications are present, complex treatment is needed. As a rule, it consists of conservative measures.

Surgery is prescribed only if conservative treatment is ineffective or in case of fragmentation of the tibial tuberosity.

Conservative treatment

A prerequisite for successful treatment of the disease is a gentle regimen. During therapy, you must completely exclude all sports.

To ensure maximum rest for the damaged area, experts recommend using special orthopedic bandages and braces that will provide protection and support for the sore knee.

The first and most important step in the treatment of Schlatter's disease of the knee joint in a teenager is to provide rest to the injured knee. To minimize mobility, a special fixing bandage is used; sports are completely excluded during rehabilitation.

Painkillers and anti-inflammatory drugs may be indicated as medical therapy if necessary. Taking vitamin E and group B, as well as calcium, has a beneficial effect on the healing process.

When the pain syndrome goes away completely, a course of therapeutic physical education (PT) is prescribed. For patients, a special course of physical exercises is selected that ensures pumping and stretching of precisely those muscle groups that will subsequently ensure the stability of the knee joint and prevent further development of the disease or its relapse.

When the inflammation of the joint is completely stopped, you can begin physiotherapeutic treatment methods, such as:

ultra-high frequency therapy (UHF);
shock wave therapy (SWT);
ultrasound therapy;
mud treatment;
electrophoresis using calcium preparations;
paraffin therapy;
magnetic therapy;
electrical stimulation.

Experts' opinions on the effectiveness of the listed methods of physiotherapy still differ, but patient reviews are usually positive. Even if these procedures do not give a positive result, in any case they do not cause a negative one.

In cases where conservative treatment does not have the expected positive result (the protrusion of the lump remains, associated with pain), surgical treatment is performed.

However, these cases are extremely rare in practice. If surgery is unavoidable, necrotic tissue lesions are eliminated and the tuberosity of the bone is fixed.

After surgery, rest and wearing a fixing bandage, followed by a course of exercise therapy, are also indicated. Return to physical activity is possible no earlier than 6 months after surgery.

Home methods for treating the disease are based on compresses, lotions and paraffin baths. An oil compress throughout the night helps the most.

To do this, you need cotton fabric or gauze, which must be folded several times. The fabric should be heated strongly with an iron and then soaked in unrefined sunflower oil.

This fabric should be applied to the sore joint, covered with polyethylene and wrapped with a warm scarf around the leg so that the compress does not slip off. This compress should be done every night for one month.

If the disease is severe, the course of treatment is extended to three months.

Possible complications

In severe cases of the disease, after completing the course of treatment, a bone growth remains in the form of a lump under the kneecap.

With incomplete treatment, pain and aching pain remain, which can regularly appear after intense physical exertion.

Osgood-Schlatter disease means not only the need for treatment, but also dramatic changes in lifestyle.

During the period of treatment and rehabilitation, you should exclude sports, adhere to a certain diet, do not forget about therapeutic exercises, and avoid overloading the joint.

Osgood-Schlatter disease is completely curable, but its treatment must be approached responsibly.

Timely diagnosis and adequate treatment of Schlatter's disease does not cause serious complications or severe consequences. However, it is impossible to predict the outcome of the disease, so prevention of the disease is necessary.

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are