Pathology, clinic, and treatment of osgood-schlatter disease.

Osgood-Schlatter disease is a disorder of enchondral ossification, and should be differentiated from heterotopic ossification in the patellar ligament. The symptoms and functional impairment arising in the former condition require treatment. Whereas many orthopedic surgeons feel that Osgood-Schlatter disease can be treated by conservative methods, others point out that surgical treatment is needed in some cases, and therefore have recommended rather extensive operative procedures. A survey of 142 patients, all initially treated by various conservative modalities, was carried out. Whereas 116 patients became thus symptom-free and regained normal function, 26 patients retained essential impairment in the use of the leg and needed surgical treatment. This operation consisted of excision of a portion of the surface of the tibial tuberosity, and multiple perforation by a thin drill point. Complete ossification of the tibial tuberosity and fusion with the tibial metaphysis was the outcome, followed by return of normal function of the leg. On the other hand, nine of the 116 conservatively treated patients returned several years later complaining of a protruding knob below the knee cap, persistent swelling in this area, and frequent soreness on kneeling or forceful use of the knee joint.