Current Management Strategies in Osgood Schlatter: A cross-sectional mixed method study.
Lyng K., Rathleff MS., Dean B., Kluzek S., Holden S.
BACKGROUND: Osgood Schlatter (OS) is the most common knee condition in adolescent athletes aged 9-16. Without evidence to guide clinical practice it is unclear how OS is managed. The aim of this study is to investigate how international healthcare professionals (General Practitioners, Physiotherapists, Rheumatologists, Sports and Exercise Medicine Doctors and Orthopaedic Surgeons) diagnose and manage OS. METHODS: This mixed-method study used a convergent parallel design. A quantitative questionnaire and semi-structured interview covered prognosis, diagnosis, treatment, and return to play of adolescents with OS. For quantitative data those who reported likely/very likely considered 'for' and unlikely/very unlikely 'against' (for specific diagnostic/management strategy). Qualitative data analysis used a phenomenological approach. RESULTS: Two hundred and fifty-one healthcare professionals completed the questionnaire. The most common diagnostic criterion was pain at the tibial tuberosity (97% for). The most common treatments were patient education (99%) and exercise therapy (92%). Other treatments options were more heterogeneous, e.g. pain medication (31% for, and 34% against). Managing training load (97%), pain intensity (87%) and psychological factors (86%) were considered the most important factors influencing the return to activities. Several themes emerged from the interviews (on N=20) including imaging, pain management, family, psychosocial factors influencing prognosis. CONCLUSION: Diagnosis criteria of OS was relatively well agreed upon, whereas triangulation of qualitative and quantitative data showed heterogeneity of treatments. Psychosocial factors including family were highlighted as critical in the management of OS.