ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Orthopedics
The Association Between Patellar Malalignment and Osgood-S chlatter Disease in Children
Provisionally accepted
- 1Anhui University of Chinese Medicine, Hefei, China
- 2First Clinical Medical College, Anhui University of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective:To investigate the association between patellar position (assessed by the Insall-Salvati index) and Osgood-Schlatter disease (OSD) in children, and to evaluate the predictive value of ISI and body mass index (BMI) for OSD. Methods: A case-control/cross-sectional study was conducted, enrolling 127 children aged 10-16 years between March 2023 and June 2025, including 76 children with OSD (observation group) and 51 healthy children (control group). ISI values were measured radiographically, and data on BMI, Visual Analogue Scale (VAS) score, gender, and recent exercise level were collected. Univariate analysis and multivariate logistic regression were used to analyze associated factors, and the predictive performance of ISI and BMI was evaluated using Receiver Operating Characteristic (ROC) curves. Results:The observation group had significantly higher ISI values, BMI values, and proportion of males compared to the control group (all P< 0.05). Multivariate logistic regression showed that male gender (OR=5.61), high BMI (OR=1.77), high ISI (OR=16.13), and recent high exercise level (OR=7.03) were independent risk factors for OSD (all P< 0.05). ROC curve analysis indicated that the area under the curve (AUC) for ISI predicting OSD was 0.933 (optimal cut-off value 1.14), superior to the AUC for BMI (0.793).Conclusion: The ISI value is a strong independent indicator associated with OSD, with an optimal cut-off value of 1.14. The pathogenesis of OSD may involve the combined effects of abnormal biomechanics (high ISI) and mechanical load (high BMI, high exercise level). Early screening of ISI may help identify high-risk individuals for targeted prevention.
Keywords: Biomechanics, Insall-Salvati index, Osgood-Schlatter disease, Patella alta, pediatric orthopaedics
Received: 24 Nov 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Yang, Long, Wang, Kuang, Wei, Wang and GUO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huibao Yang
Dawei Long
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.