The sequelae of Osgood-Schlatter's disease in adults

Abstract

Seven adults with the sequelae of Osgood-Schlatter's disease presented after experiencing symptoms for an average of eight years. In four cases a true joint had formed between an ossicle in the patellar ligament and a facet on the tibia. Surgical treatment produced good results in all of the patients. Treatment differs from that in children in whom the epiphyseal lines are open.

Results of Surgical Treatment of Unresolved Osgood-Schlatter Disease in Adults

“…Nevertheless, not all cases of Osgood-Schlatter disease will resolve completely at maturity. [6][7][8][9][10][11] In a review of the natural history of untreated Osgood-Schlatter disease, Krause and coworkers 8 have found that 76% of patients thought they had no limitation of activity; however, only 60% could kneel without discomfort. It is expected that the continued symptoms of Osgood-Schlatter disease in adulthood may be more evident and more disabling in the populations who require prolonged hyperflexion of the their knees or kneeling due to religious, social, or employment causes.…”

“…9 However, most authors found a lower incidence of separate ossicle in their patients, ranging from 50 to 70%. [6][7][8] Woolfrey and Chandler noted that the shape of tibial tubercle was more irregular in their older age group of patients. 6 The difference between the more advanced pathology in our series compared with other studies may be related to the older age of our patients.…”

“…All our patients were skeletally mature, with mean age of 22.5 years old, which is older than the mean age of other studies. 7,9,12,14 When symptoms persist after skeletal maturity, surgical treatment may be warranted. There are many surgical options for unresolved Osgood-Schlatter disease including drilling of the tubercle, removal of the loose fragments, autogenous bone peg insertion through the tubercle (to obtain epiphysiodesis of the anterior tibial apophysis), tibial tubercle excision, and excision of the un-united ossicles.…”

“…Radiographs usually demonstrate an enlarged tibial tubercle with a free ossicle sometimes seen anterior and superior to the attachment of the patellar ligament to the tibial tubercle. [4][5][6][7][8] The mainstay of treatment of Osgood-Schlatter disease is nonoperative in the form of activity modification, ice, anti-inflammatory medications, short-term bracing, physical therapy (e.g., hamstring stretching), and sometimes cast immobilization.…”

“…However, a few patients continue to suffer from pain throughout adulthood and will have some restrictions of their activities. 6,7,[9][10][11][12] In this study, we describe the pathology of the Osgood-Schlatter disease in the adult population. We also discuss our surgical technique and our results of surgical treatment of Osgood-Schlatter disease in adults.…”