A surgical procedure for the Osgood-Schlatter lesion

Abstract

Although the Osgood-Schlatter lesion (OSL) usually heals spontaneously, symptoms often continue for 2 or 3 years. Affected young people are often keen on sporting or strenuous activities, and enforced reduced physical activity may cause considerable frustration and emotional disruption. A simple procedure which had been advocated for severely affected children wanting to be active in sports was evaluated. The procedure promised to alleviate pain and allow pa tients to return to unrestricted sporting activities within a short period without fear of relapse. It involved splitting the quadriceps tendon vertically along the line of its fibers and removing the avulsed fragments by excising any attachment between the fragment and the cartilage or bone of the anterior portion of the proximal tibial apophysis. The results in 66 patients who underwent this pro cedure were reviewed, with an average follow-up time of 4.8 years. There were 11 bilateral cases, making 77 lesions. The average patient age was 13.5 years. Sixty patients indicated at the time of surgery that they had been keen on sporting activities. The average preoperative duration of symptoms was 13 months. Postoperatively, patients regained ability to participate in full sporting activities after an average 3.8 months. There were no relapses. The most frequent long-term complaints after surgery related to residual promi nence of the tibial tuberosity, reported in 25% of the cases. There were no cases of genu recurvatum. From these results, we recommend the operation for pa tients with OSL whose disability recurs after prolonged conservative treatment or as a primary procedure in severely affected young people especially keen on sporting activities.