Standard knee arthroscopy with free ossicle removal and tubercleplasty provides optimal results for unresolved Osgood-Schlatter disease: A case series and literature review.

Abstract

To present a consecutive case series of patients with unresolved Osgood-Schlatter disease (OSD) treated arthroscopically with ossicle excision and tubercleplasty and to give a literature overview of both open and arthroscopic/endoscopic surgical treatment reports. Knee arthroscopy was performed using a high anterolateral and standard anteromedial portals. Anterior interval release was performed to access the area between the patellar tendon and the anterior tibial surface. Infrapatellar bursa was resected and the ossicles were removed. Afterwards, tubercleplasty was performed along with debridement of the distal portion of the patellar tendon. Twelve patients (seven male) participated in the study. Mean patient age was 21.7 (range, 18-28) years. Patients experienced refractory symptoms for a mean duration of 77 (range, 24-192) months. No intraoperative complications occurred. Postoperative period was uneventful. Mean follow up duration was 77.3 (range, 29-134) months. At final follow up, Kujala score and Lysholm knee scoring scale improved significantly from a preoperative mean of 69.9 (range, 52-84) to 98.5 (range, 92-100) and 76.3 (range, 60-92) to 99.5 (range, 95-100), respectively. Postoperatively, all patients were able to return to preinjury levels of sport activity. Standard arthroscopy allows adequate visualization of the space between patellar tendon and anterior tibial surface, enabling ossicle removal with patellar tendon debridement and tubercleplasty. Anterior interval release in experienced hands poses minimal risk of damaging the intermeniscal ligament, anterior meniscal horns or patellar tendon. Therefore, we advocate standard knee arthroscopy as superior among currently described techniques for unresolved OSD.