Arthroscopic Excision of a Huge Ununited Ossicle Due to Osgood-Schlatter Disease in an Adult Patient

What to Learn from this Article?

 1. Adult presentation of Osgood schlatter disease?

2.Technique of arthroscopic removal of large ossicles from behind the patella tendon?


Case Report: Volume 3 | Issue 2 | JOCR April – June 2013 | Page 4-7 | Li Zhi-Yao


Author [1] LI Zhi-yao

[1] Department of Arthroscopy and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China.

Address of Correspondence:

Dr LI Zhi-yao: Department of Arthroscopy and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China. Email: zhiyao.li@hotmail.com


Abstract

Introduction: Surgical excision of the ununited ossicles has been suggested for unresolved sequelae of Osgood-Schlatter disease in adults resistant to conservative measures. We report a case where arthroscopy was used to excise the ossicles. A bird eye view from the superolateral portal was helpful in the arthroscopic procedure for excision of the deep low lesion.

Case Report: A 32-year-old, male driver had anterior knee pain during walking and sports activity that had been treated conservatively for 3 months. On physical examination, there was a prominent tibial tubercle, but without palpable pain. There was obvious pain when the knee was approaching full extension. On image, a huge ununited ossicle was seen behind the patellar tendon, intruding into the joint space, and there was another two small ununited ossicles beneath the bow-shaped patellar tendon. Arthroscopy was performed through a three portals technique, and a bird eye view was achieved from the superolateral portal. The ossicles were separated from the surrounding soft tissue with a motorized shaver. The small ununited ossicles were removed by use of a grasper. The huge ossicle was removed by use of a motorized bur, and the contouring of the irregular surface of the tibial tubercle was performed. After 3 months, the patient returned to sports activities without any restrictions.

Conclusion: This report shows that a huge ossicle can cause impingement in anterior knee compartment, and it can be easily removed arthroscopically under assistance of an additional portal.

 Keywords: Osgood-Schlatter disease; Knee; Arthroscopy; Superolateral portal.


 

How to Cite This Article: Li Zhi-Yao. Arthroscopic Excision of a Huge Ununited Ossicle Due to Osgood-Schlatter Disease in an Adult Patient. J Orthopaedic Case Reports 2013 April-June;3(2):4-7Available from:http://www.jocr.co.in/wp/wp-content/uploads/Jan-March-2013-Article-3.pdf


(Figure 1) | (Figure 2a) | (Figure 2b) | (Figure 3) | (Figure 4)


 

Dr. LI Zhi-yao


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