Complete resolution of the symptoms of refractory Osgood-Schlatter disease following percutaneous fixation of the tibial tuberosity

Abstract

SUMMARYOsgood-Schlatter disease is a common cause of anterior knee pain in adolescents. In a good proportion of cases the pain is relieved through stopping sport alone, or by doing so in conjunction with undertaking physiotherapy. However, resolution of symptoms may take several years. A proportion of teenagers are prevented from participating in sport for a prolonged period as a result of the condition, and some have persisting knee pain into adulthood. We report the use of a new surgical treatment for this disease. We describe the case of a 12-year-old boy who was unable to play rugby for a year due to this pain. Following percutaneous fixation of the tibial tuberosity his symptoms entirely resolved and he returned to competitive sport 6 weeks after surgery. A year later the screw was removed. As soon as he resumed sport his symptoms immediately returned and he requested that the screw be replaced. Following replacement his symptoms once more resolved. BACKGROUND

Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease

“…Despite that favorable natural progress has been recognized as a self-limiting disease in 90% of the patients, severe pain in the tibial tuberosity and difficulties in daily life are often complained by athletes or military personnel who frequently perform activities that cause stress on the knee joint regardless of the completion of the growth 2) . Various treatment methods including surgical treatment have been performed for the patients with severe symptoms refractory to conservative treatment 2 3 4 5 6 7 8) ; however, cases where the symptoms persist even after surgical treatment have often been reported 3 4 9 10 11 12) . This has been thought to be due to the lack of research on pathophysiology and clinical progress of the disease.…”

Endoscopic Management of Osgood-Schlatter Disease

“…O sgood-Schlatter disease (osteochondrosis of the tibial tubercle) is a common cause of anterior knee pain in sports-practicing adolescents. 1,2 Traditionally, it is treated with restriction from sports alone or in conjunction with undertaking physiotherapy. The goals of conservative treatment are to lessen the stress on the tibial tubercle and to reduce the tension in the quadriceps muscle.…”

“…A proportion of teenagers are prevented from participating in sports for a prolonged period as a result of the condition, and some have persisting knee pain into adulthood. 2 Conservative treatment with rest, lidocaine injections, steroid injections, cylinder casts, and infrapatellar straps has been proposed for adults with continued symptoms. 4 Surgical treatment is indicated if they do not respond to conservative measures.…”

Intra-articular Large Ossicle Associated to Osgood-Schlatter Disease

“…Recently, Pagenstert et al have reported a satisfactory result after treatment of refractory OSD by reduction osteotomy of tibial tubercle [ 17 ]. Also, there was a case report showing the effect of repetitive percutaneous screw fixation of tibial tuberosity for adolescent OSD [ 18 ]. However, it should be noted that most of the studies were case reports with small subject numbers.…”