REF-1063 · Neuhaus et al., 2021 · Physical Therapy in Sport, · Paper · PubMed

A systematic review on conservative treatment options for Osgood-Schlatter disease

Up to 10% of adolescents are affected by this sport- and growth-associated knee condition; thirteen studies (only two RCTs, quality poor to moderate) covering 747 patients and 937 knees found apparent efficacy for some approaches such as stretching, but no RCT compares specific exercises with sham or usual care

B+moderate evidenceMeasured on non-to trained athletesWritten before October 2026, being re-checked

Systematic review of conservative treatment for Osgood-Schlatter disease (OSD) — a knee condition linked to sport and growth, with local painful changes around the tibial tuberosity apophysis. Abstract only was read. The aims were to find the conservative options, compare how well they work on selected outcomes and map research gaps; treatment recommendations were also extracted from review articles.

Participants

747 patients with 937 affected knees across the thirteen included studies, published from 1948 to 2019 (abstract). Ages and sports are not given in the abstract.

Protocol

Systematic search of PEDro, MEDLINE, EMBASE, CINAHL and CENTRAL, as well as clinical studies still ongoing or unpublished, dissertations and other OSD grey literature (abstract).
Review articles were systematically retrieved to extract treatment recommendations; 15 review articles were included and the most prevalent recommendations compiled (abstract).

Key Results

OSD affects up to 10% of adolescents and is mostly treated conservatively (abstract).
767 studies were identified and thirteen included; just two of those were randomised controlled trials (abstract).
Study quality was poor to moderate (abstract).
Some therapeutic approaches, stretching among them, appear to work, yet no RCT has tested specific exercises against sham or usual-care treatment (abstract).
To learn which conservative options work best, well-described treatments need testing in carefully controlled studies (abstract).

Practical Application

**My teenager has pain just below the kneecap — is there a proven exercise fix?A systematic review (Neuhaus 2021, B+, adolescents with Osgood-Schlatter disease, all sports) found that treatment is mostly conservative and that approaches such as stretching look helpful, but only two of thirteen studies were randomised and no trial compares a specific exercise programme with sham or usual care — so there is no proven protocol, and the assessment and plan belong to a clinician.**
The condition is common in adolescence (up to 10% affected, abstract), so growth-site pain at the front of the knee in a growing rider is a reason to involve a parent and a clinician, not to push through (SYNTH-81, SYNTH-73).
The assistant repeats what the athlete reports and never names the diagnosis itself (SYNTH-73).
Inference, not tested here: on the bike, reducing load that provokes the pain while a clinician assesses it follows the base's general swap-not-drop rule; this review does not test cycling or load modification.

Limitations

Thirteen heterogeneous studies spanning 1948 to 2019, only two RCTs, quality poor to moderate; no pooled effect sizes are reported in the abstract.
The abstract does not name which treatments were compared beyond stretching, nor outcome sizes.
Not specific to cyclists; abstract only was read.
How this entry was checked and changed
Why this level

a systematic review, but only two of the thirteen included studies were RCTs and study quality was poor to moderate, so it sits below the rubric's A- row (SR of mostly small trials)