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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having Hurt In Knees, Swelling. What Can I Do?

I have Osgood-Schlatters and my knees really hurt. My knees are really swelling up and i can barely walk on my legs because of it. My older brother had it so my mum isn t very sympathetic so she just says to ice it and move on with life, i have tried to but since i go to school it hurts to walk to class and go up all the stairs. Im not sure if crutches will help or if (as my mum tells me) will just make it heal slower and hurt more. Please help. Thanks From Georgie
Thu, 21 Feb 2013
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General & Family Physician 's  Response
Hi,
thank you for query.
the treatment and management of osgood schlatter disease is-
Diagnosis is made clinically, and treatment is conservative with RICE (Rest, Ice, Compression, and Elevation), and if requiredacetaminophen (paracetamol), ibuprofen and/or Co-Codamol or stronger if in 'acute phase' & (the pain is severe and continuous in nature). The condition usually resolves in a few months, with a study of young athletes revealing a requirement of complete training cessation for 1 week (on average) and gradual resumption of full training by 1 month., Bracing or use of an orthopedic cast to enforce joint immobilization is rarely required and does not necessarily give quicker resolution. Sometimes, however, bracing may give comfort and help reduce pain as it reduces strain on the tibial tubercle.] Surgical excision may rarely be required in skeletally mature patients.[ In chronic cases that are refractory to conservative treatment, surgical intervention yields good results, particularly for patients with bony or cartilaginous ossicles. Surgery is usually a good idea for patients that will no longer grow but the knee is still affected by Osgood-Schlatters disease. Excision of these ossicles produces resolution of symptoms and return to activity in several weeks. After surgery, it is common for lack of blood flow to below the knees and to the feet. This may cause the loss of circulation to the area, but will be back to normal again shortly. A high pain may come and go every once and a while, due to the lack of blood flow. If this happens, sitting down will help the pain decrease. Removal of all loose intratendinous ossicles associated with prominent tibial tubercles is the procedure of choice, both from the functional and the cosmetic point of view. According to one study, in the great majority of young adults, the functional outcome of surgical treatment of unresolved Osgood-Schlatter disease is excellent or good, the residual pain intensity is low, and postoperative complications or subsequent reoperations are rare.]
After symptoms have resolved, a gradual progression to the desired activity level may begin. In addition, predisposing factors should be evaluated and addressed. Commonlyquadriceps and/or hamstring tightness is present and should be addressed with stretching exercise.
After being clinically diagnosed the patient should rest for at least 3 days and must try not to use the knee as hard for about 1–2 weeks without any physical activities. If the disease continues to a certain extent where the patient cannot move the joint then they should seek medical advice right away as although this is very rare it can be severely limiting for the patient's sporting future if it does occur. The Strickland Protocol has shown a positive response in patients with a mean return to sport in less than 3 weeks.

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Having Hurt In Knees, Swelling. What Can I Do?

Hi, thank you for query. the treatment and management of osgood schlatter disease is- Diagnosis is made clinically, and treatment is conservative with RICE (Rest, Ice, Compression, and Elevation), and if requiredacetaminophen (paracetamol), ibuprofen and/or Co-Codamol or stronger if in acute phase & (the pain is severe and continuous in nature). The condition usually resolves in a few months, with a study of young athletes revealing a requirement of complete training cessation for 1 week (on average) and gradual resumption of full training by 1 month., Bracing or use of an orthopedic cast to enforce joint immobilization is rarely required and does not necessarily give quicker resolution. Sometimes, however, bracing may give comfort and help reduce pain as it reduces strain on the tibial tubercle.] Surgical excision may rarely be required in skeletally mature patients.[ In chronic cases that are refractory to conservative treatment, surgical intervention yields good results, particularly for patients with bony or cartilaginous ossicles. Surgery is usually a good idea for patients that will no longer grow but the knee is still affected by Osgood-Schlatters disease. Excision of these ossicles produces resolution of symptoms and return to activity in several weeks. After surgery, it is common for lack of blood flow to below the knees and to the feet. This may cause the loss of circulation to the area, but will be back to normal again shortly. A high pain may come and go every once and a while, due to the lack of blood flow. If this happens, sitting down will help the pain decrease. Removal of all loose intratendinous ossicles associated with prominent tibial tubercles is the procedure of choice, both from the functional and the cosmetic point of view. According to one study, in the great majority of young adults, the functional outcome of surgical treatment of unresolved Osgood-Schlatter disease is excellent or good, the residual pain intensity is low, and postoperative complications or subsequent reoperations are rare.] After symptoms have resolved, a gradual progression to the desired activity level may begin. In addition, predisposing factors should be evaluated and addressed. Commonlyquadriceps and/or hamstring tightness is present and should be addressed with stretching exercise. After being clinically diagnosed the patient should rest for at least 3 days and must try not to use the knee as hard for about 1–2 weeks without any physical activities. If the disease continues to a certain extent where the patient cannot move the joint then they should seek medical advice right away as although this is very rare it can be severely limiting for the patient s sporting future if it does occur. The Strickland Protocol has shown a positive response in patients with a mean return to sport in less than 3 weeks.