Arthroscopic Resection of Symptomatic Tibial Tubercle Ossicles for Recalcitrant Osgood-Schlatter Disease Using a 2-Portal Technique

Arthroscopic resection of symptomatic unfused tibial tubercle ossicles causing chronic anterior knee pain due to recalcitrant Osgood-Schlatter disease has been shown to be a reproducible arthroscopic technique. Although a number of other surgical techniques have been described, including ossicle excision and tubercle-plasty, drilling of the tibial tubercle, bone peg insertion to induce fusion, open excision of loose fragments, direct bursoscopic ossicle resection, and closing-wedge tubercle osteotomy, with varied outcomes, this technique offers a minimally invasive approach with low risk. Complications including injury to the patellar tendon and scarring of the anterior fat pad have been previously reported, but this approach can be performed with minimal fat pad debridement and direct visualization of the patellar tendon during all resections. This article presents a technique for arthroscopic resection and debridement of unfused ossicles in patients with chronic anterior knee pain due to Osgood-Schlatter disease by use of minimally invasive arthroscopic techniques that are used in standard knee arthroscopy and should be familiar to most arthroscopists.