Osgood-Schlatter Disease in youth elite football: Minimal time-loss and no association with clinical and ultrasonographic factors
M.J. Schultz, Johannes L. Tol, Linda Veltman, Lisanne Kaaden van der, Gustaaf Reurink
Abstract
BACKGROUND: Osgood-Schlatter Disease is the most common cause of knee pain in youth. Scientific research in youth elite football is limited. OBJECTIVES: To assess clinical and ultrasonographic factors associated with Osgood-Schlatter Disease and calculate point prevalence of clinical diagnosis and time-loss in youth elite male football. STUDY DESIGN: Nested case-control study and cross-sectional prevalence study; Level of evidence: 3. METHODS: We obtained data during the pre-season periodic health evaluation. Osgood-Schlatter Disease diagnosis was defined as (1) athlete-reported anterior knee pain and (2) clinical confirmation by pain provocation at the tibial tuberosity. Time-loss was defined as inability to participate in team training and/or competition. For the nested-case control study, we examined clinical and ultrasonographic factors in the U13 to U16 teams. We matched on calendar-age. The clinical factors were: self-reported history of Sever's disease, growth measures, leg muscles flexibility and strength and ultrasonographic bone maturity stages according to Ehrenborg, For the cross-sectional study, we included players of the U13 to U19 teams to calculate the point prevalence. RESULTS: The case-control study consisted 30 players and the cross-sectional study 127 players. Previous Sever's disease was strongly associated with Osgood-Schlatter Disease (OR = 16.8; p = 0.02; 95% CI = 1.6-174.5). None of the other clinical or ultrasonographic factors were associated. The point prevalence was 17% and 80% had no time-loss despite presence of clinical symptoms. CONCLUSION: Considering the 16.8OR, previous Sever's disease indicates a strong association with Osgood-Schlatter Disease. Although generally suggested, growth velocity and bone maturity are not associated in an age-matched comparison.