Osgood-Schlatter Disease in an Adult Athlete: A Case Report and Review of the Literature
Abstract
Background: Osgood-Schlatter disease (OSD), a form of traction apophysitis, predominantly affects adolescents engaged in high- impact activities. While conservative management is often effective, surgical intervention becomes necessary in refractory cases.
Case Report: A 29-year-old male athlete with persistent OSD symptoms underwent arthroscopic surgery after unsuccessful non- surgical treatments. Arthroscopic removal of the bony particle was undertaken using six portals with a novel setting (consisting of medial and lateral superior, standard, and inferior portals) to minimize the damage to the patellar tendon and intermeniscal ligaments. This setting of portals also obviates the need for fluoroscopy since it provides adequate visualization for confirmation of complete removal of the bony particle. The lower portals also provide more convenient access to the bony particle, minimizing the possibility of incomplete removal and persistence of symptoms. The patient experienced complete resolution of anterior knee pain and prominence within six months post-surgery. Arthroscopic removal of the ossicle involved the use of superior portals for optimal access and visualization. Low portals were strategically employed to eliminate the need for fluoroscopy, offering a unique advantage. Postoperative rehabilitation included immobilization followed by a gradual return to weight-bearing and full range of motion (ROM).
Conclusion: Arthroscopic removal remains the preferred method for treating OSD, emphasizing fewer complications. However, challenges related to limited access and anatomical restoration persist.
2. Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter syndrome. Curr Opin Pediatr. 2007;19(1):44-50. doi: 10.1097/MOP.0b013e328013dbea. [PubMed: 17224661].
3. Glynn MK, Regan BF. Surgical treatment of Osgood-Schlatter's disease. J Pediatr Orthop. 1983;3(2):216-9. doi: 10.1097/01241398- 198305000-00012. [PubMed: 6863528].
4. Maffulli N, Grewal R. Avulsion of the tibial tuberosity: Muscles too strong for a growth plate. Clin J Sport Med. 1997;7(2):129-32. [PubMed: 9113430].
5. Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood-Schlatter disease: Review of the literature. Musculoskelet Surg. 2017;101(3):195-200. doi: 10.1007/s12306-017-0479-7. [PubMed: 28593576].
6. Holden S, Olesen JL, Winiarski LM, Krommes K, Thorborg K, Holmich P, et al. Is the prognosis of osgood-schlatter poorer than anticipated? A prospective cohort study with 24-month follow-up. Orthop J Sports Med. 2021;9(8):23259671211022239. doi: 10.1177/23259671211022239. [PubMed: 34435066]. [PubMed Central: PMC838144].
7. Lui TH. Endoscopic management of Osgood-Schlatter disease. Arthrosc Tech. 2016;5(1):e121-e125. doi: 10.1016/j.eats.2015.10.023. [PubMed: 27073771]. [PubMed Central: PMC4811213].
8. Weiss JM, Jordan SS, Andersen JS, Lee BM, Kocher M. Surgical treatment of unresolved Osgood-Schlatter disease: Ossicle resection with tibial tubercleplasty. J Pediatr Orthop. 2007;27(7):844-7. doi: 10.1097/BPO.0b013e318155849b. [PubMed: 17878797].
9. Binazzi R, Felli L, Vaccari V, Borelli P. Surgical treatment of unresolved Osgood-Schlatter lesion. Clin Orthop Relat Res. 1993;(289):202-4. [PubMed: 8472416].
10. DeBerardino TM, Branstetter JG, Owens BD. Arthroscopic treatment of Arthroscopy.10.1016/j.arthro.2006.12.004. [PubMed: 17916481].
11. Erkocak OF, Aydin BK, Altan E, Acar MA. Arthroscopic removal of an Ununited Ossicle due to persistent Osgood Schlatter disease. Chirurgia. 2013;26(1):45-7.
12. Lee YS, Ahn JH, Chun DI, Yoo JH. A case of arthroscopic removal of symptomatic ossicle associated with Osgood'Schlatter disease in an athletic. Eur J Orthop Surg Traumatol. 2011;21(4):301-4. doi: 10.1007/s00590-010-0697-2.
13. Lui TH. Endoscopic resection of avulsed fragment of tibial tuberosity and endoscopic-assisted repair of patellar tendon. Arthrosc Tech. 2015;4(6):e851-e854. doi: 10.1016/j.eats.2015.08.011. [PubMed: 27284523]. [PubMed Central: PMC4887428].
14. Fujita K, Nakase J, Yoshimizu R, Kimura M, Kanayama T, Tsuchiya H. Bursoscopic ultrasound-guided Ossicle resection for Osgood-Schlatter disease. Arthrosc Tech. 2022;11(5):e841- e846. doi: 10.1016/j.eats.2021.12.043. [PubMed: 35646559]. [PubMed Central: PMC9134316].
15. Pagenstert G, Wurm M, Gehmert S, Egloff C. Reduction osteotomy of the prominent tibial tubercle after Osgood- Schlatter disease. Arthroscopy. 2017;33(8):1551-7. doi: 10.1016/j.arthro.2017.02.012. [PubMed: 28454996].
Files | ||
Issue | Vol 10 No 3 (2024) | |
Section | Case Report | |
DOI | https://doi.org/10.18502/jost.v10i3.16790 | |
Keywords | ||
Arthroscopic Surgery Case Reports Osgood-Schlatter Disease Traction |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |