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Journal of Bone and Joint Surgery, 1956;38:142-148.
© 1956 by The Journal of Bone and Joint Surgery, Inc

OPERATIVE TREATMENT OF OSTEOCHONDRITIS OF THE TIBIAL TUBERCLE

J. E. M. Thomson M.D.1

1 Lincoln Orthopaedic Center, Lincoln

An adolesent child, having a painful enlargement of the tibial tubercle and disability, neither of which respond to conservative measures, in whom periods of disability are accompanied by recurrent episodes of pain, deserves surgical treatment which will remove the deformity, cure the discomfort and disability, with the least risk and the shortest period of convalescence.

Drilling, pegging, and removal of fragments followed by impaction, can be used successfully to fuse the tubercle and to relieve the symptoms, but an unpleasant deformity often remains, unless the tubercle is completely removed. Removal gives a good result cosmetically.

Over a twenty-year period, thirty-one patients with so called "Osgood-Schlatter's disease" have been treated surgically. Ten of these had bilateral lesions bringing the total number of knee operations to forty-one.

Of this group, thirteen were over ten years of age and under fourteen years of age. Eighteen were over fourteen years of age. The results were uniformly satisfactory with the exception that those having drilling and bone-pegging had increased deformity, and those having subcortical removal of loose fragments and deforming material with impaction and those having complete removal of the entire tubercle have a much better cosmetic and functional result because a deforming prominence which might be easily injured is removed.

Removal of the tubercle is the surest and shortest procedure to bring about a complete and lasting cure.


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