Surgical Treatment of Patellar Tendinopathy/Osgood–Schlatter’s Disease

Abstract

Pathology of the patellar tendon can be a common cause of anterior knee pain, particularly among athletic individuals. The patellar tendon forms the extensor mechanism along with the quadriceps tendon and attaches the patella to the tibial tuberosity of the anterior tibia. The extensor mechanism, and specifically the patellar tendon, is actively involved in movement of the knee joint, acting over a large lever arm fulcrumed by the patella (Newell and Bramwell, Phys Sportsmed. 12:80–92, 1984). This role predisposes the tendon to overuse injury, both at the proximal aspect of the tendon and at the inferior pole of the patella, as well as at its distal insertion. Tendonitis at the inferior pole is broadly classified as patellar tendinopathy and known colloquially as “jumper’s knee” in reference to the athletic subpopulation in which it is most observed. Children and adolescents are also at risk for a specific inflammation of the patellar tendon insertion described as an apophysitis of the tibial tuberosity, more commonly referred to as Osgood–Schlatter disease (OSD) or Lannelongue’s disease (Kujala et al. Am J Sports Med. 13(4):236–41, 1985; Ladenhauf et al. Curr Opin Pediatr. 32(1):107–12, 2020). While both patellar tendinopathy and OSD are commonly managed nonoperatively, progression or persistence of symptomology can warrant surgical intervention.