Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Osgood-Schlatter’s Disease

SYMPTOMS

There is gradual onset of localised exercise-induced pain and soreness at rest around the tuberositas tibia of the knee in a young growing athlete, usually 12 to 16 years old, without preceding trauma. It may be bilateral or affect the knees separately, depending on the growth of each leg.

AETIOLOGY

The condition is caused by excessive stress to the growth plate (apophysis) where the patellar tendon inserts on the tibia. This condition typically occurs as a result of a sudden growth spurt and is aggravated by jumping and running. It is therefore often misunderstood as an over-use condition in sporty children.

CLINICAL FINDINGS

There is localised tenderness on palpation over the tuberositas tibia, sometimes associated with swelling and a palpable lump.

INVESTIGATIONS

X-ray defines the diagnosis and rules out rare bony tumours.

TREATMENT

This temporary condition should be explained to the child and parents and treated by suggesting temporary modifications in training. The pain will disappear when the growth plate closes.

REFERRALS

Refer to Dr Kevin Yip, consultant senior orthopaedic surgeon for planning of a six to twelve months’ modified return programme back to full sport.

EXERCISE PRESCRIPTION

Avoid painful activities but do not advocate complete rest. It is important to keep these young athletes with their team or in their sport by participating in less painful activities so they don’t lose contact and stop playing. Cycling, freestyle swimming and most low-impact activities are good alternatives to keep up general
fitness.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs.

DIFFERENTIAL DIAGNOSES

Bone tumour (rare but must not be missed).

PROGNOSIS

Excellent. However, since symptoms usually last a very long time, many young professional players are wrongly excluded from their team during a sensitive period of their development.

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