The Journal of Bone and Joint Surgery (American). 2009;91:2350-2358.
doi:10.2106/JBJS.H.01796
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Long-Term Outcome After Surgical Treatment of Unresolved Osgood-Schlatter Disease in Young Men

Harri K. Pihlajamäki, MD, PhD1, Ville M. Mattila, MD, PhD1, Mickael Parviainen, MD1, Martti J. Kiuru, MD, PhD, MSc2 and Tuomo I. Visuri, MD, PhD1

1 Research Department, Centre for Military Medicine, P.O. Box 50, FIN 00301 Helsinki, Finland. E-mail address for H.K. Pihlajamäki: harri.pihlajamaki{at}helsinki.fi. E-mail address for V.M. Mattila: ville.mattila{at}uta.fi. E-mail address for M. Parviainen: mikko.parviainen{at}orton.fi. E-mail address for T.I. Visuri: tuomo.visuri{at}helsinki.fi
2 Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, FIN 00029 Helsinki, Finland. E-mail address: martti.kiuru{at}terveystalo.com

Investigation performed at the Research Department, Centre for Military Medicine; Department of Orthopaedic Surgery, Central Military Hospital; and Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: Surgical treatment of Osgood-Schlatter disease is occasionally warranted, but its long-term prognosis remains poorly investigated. We studied the rate of occurrence of surgical treatment of unresolved Osgood-Schlatter disease as well as the clinical course, radiographic characteristics, and long-term outcomes after that treatment in a large population of military recruits.

Methods: During a thirteen-year period, 178 consecutive recruits underwent surgery for unresolved Osgood-Schlatter disease, and 107 of them (117 knees) who met the inclusion criteria participated in a follow-up examination. We obtained data from the original medical records and radiographs as well as follow-up information from physical and radiographic examinations, interviews, and questionnaires to determine functional outcomes.

Results: The rate of occurrence of surgically treated unresolved Osgood-Schlatter disease was forty-two per 100,000 military recruits. The median age at the onset of symptoms was fifteen years. After a median duration of follow-up of ten years after the surgery, ninety-three patients (87%) reported no restrictions in everyday activities or at work and eighty (75%) had returned to their preoperative level of sports activity. The median modified Kujala score was 95 points, and the median visual analog score for pain was 7 mm. Forty-one patients (38%) reported a complete absence of pain when kneeling. Six patients had experienced minor postoperative complications, and two had undergone a reoperation for the treatment of the Osgood-Schlatter disease. After resection, the mean tibial tuberosity thickness decreased by 47%. The mean Insall-Salvati index was 1.0 preoperatively and 1.09 postoperatively (p = 0.003), and the corresponding mean Blackburne-Peel indexes were 0.85 and 0.95 (p = 0.003). With the numbers studied, the symptom duration, surgical methods, and radiographic indexes were not found to have an effect on the outcome of surgery.

Conclusions: In the great majority of young adults, the functional outcome of surgical treatment of unresolved Osgood-Schlatter disease is excellent or good, the residual pain intensity is low, and postoperative complications or subsequent reoperations are rare.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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