Which anatomical variation in females contributes to a higher incidence of Osgood-Schlatter syndrome compared to males?

• A. Decreased pronation
• B. Decreased Q angle
• C. Increased femoral anteversion
• D. Genu varus

Answer: (C)

Osgood-Schlatter syndrome occurs from repetitive traction of the patellar tendon on the tibial tubercle during growth spurts. Anything that increases the tensile forces at that apophysis during activities like jumping or sprinting raises the risk.

Increased femoral anteversion causes the femur to sit more internally rotated, which alters knee alignment and places the knee under greater valgus/rotational stress during dynamic activities. This shifts the mechanics so the quadriceps–patellar tendon complex pulls more forcefully on the tibial tubercle, heightening traction at the insertion point. That augmented traction during growth years explains why this anatomical variation is linked with a higher incidence of Osgood-Schlatter in females.

The other options don’t produce the same increase in tibial tubercle traction: changes like decreased pronation, decreased Q angle, or genu varus tend to reduce or alter knee mechanics in ways that don’t specifically amplify the traction at the tibial tubercle during quadriceps loading.