Treatments for Osgood Schlatter Disease: A Systematic Review of the Literature

Osgood-Schlatter Disease (OSD) is an overuse injury causing pain and inflammation at the tibial tubercle, usually in skeletally immature patients. Various treatments are available, including surgical and nonsurgical approaches.

To review the literature focusing on the clinical outcomes of different treatments for OSD.

Scoping review; Level of evidence, 4.

Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search was performed in June 2024 with PubMed, Embase, and Cochrane Trials, totaling 349 initial articles. Data were collected on patient demographics, treatments, clinical outcomes, and complication rates. Bias was assessed using the methodological index for non-randomized studies and risk of bias 2.0 tools.

Fifteen studies encompassing 712 patients were included and categorized into nonoperative (n = 7), injection-based (n = 4), and surgical (n = 6) treatment groups. Among injection studies, full recovery rates ranged from 31.8% to 84.3%, with the Knee injury and Osteoarthritis Outcome Score and Tegner Activity Scale (TAS) scores as high as 94.3 and 6.3, respectively, after treatment. Dextrose and platelet-rich plasma injections demonstrated no reported complications. Nonoperative treatments, including physical therapy, immobilization, and supportive care, showed full recovery of activities of daily living (ADL) in 14.3% to 100% of cases. Complication rates for nonoperative treatments ranged from 0% to 66.7%, most commonly involving quadriceps atrophy and skin irritation. Surgical treatments were typically reserved for refractory cases and achieved return to ADL in 79% to 100% of patients. Postoperative Lysholm scores ranged from 96.9 to 99.0, and TAS scores ranged from 6.2 to 8.5. However, complications were reported in 5 of 6 surgical studies, with rates ranging from 0% to 75.8%, including infections, hypertrophic scarring, and residual pain.

Our systematic review showed that nonoperative treatments are effective for managing OSD. Surgery, while rare, seems reserved for patients with closed growth plates who have persistent symptoms. This review highlights the need for additional studies to better identify the best nonsurgical treatment.