The Incidence and Management of Osgood-Schlatter Disease in General Practice

Abstract

Background: Osgood-Schlatter disease (OSD) is a non-traumatic knee problem that primarily observed in sports active children and adolescents between the age of 8 and 15. Aim: The objective of this study was to determine the incidence of OSD and to gain insight into the management of children and adolescents with OSD in general practice. Design and Setting: A retrospective cohort study was conducted using a healthcare database containing full electronic health records of over 200.000 patients in general practice in and around the Dutch city of Rotterdam. Methods: Patients with a new diagnosis of OSD between the years 2012-2018 were extracted using a search algorithm based on International Classification of Primary Health Care (ICPC) coding and search terms in free text. Data on the management of OSD were manually interpreted. Results: The mean incidence over the study period was 3.8 (95% CI 3.5-4.2) per 1000 person years in the age group of 8-19 years. Boys had a higher incidence rate of 4.9 (95% CI 4.3-5.5) compared to girls, at 2.7 (95% CI 2.3-3.2). Peak incidence was at age 12 for boys and at age 11 for girls. Advice was the most commonly applied strategy (55.1%), followed by rest (21.0%) and referral for imaging (19.5%) and physiotherapy (13.4%). Conclusion: For the first time the incidence of OSD is calculated using GP electronic medical files. There is a discrepancy, especially for imaging and referral to a medical specialist, between the current general practice guideline and what GPs actually recommended.