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

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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://test.jocr.co.in/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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