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- Discussion:
    - type of juvenile traction osteochondritis;
    - refers to partial avulsion of the tibial tuberosity (anterior surface of apophysis) which has no involvement of tibial physis;
    - usually occurs in late childhood or early adolescence;
    - more common in boys;
    - may represent an over use disease;
    - condition occurs at a time when increasing demands are made on a still immature skeleton;
    - repetitive stress on tuberosity may cause partial avulsion;
    - a painful non union will develop, if intervening gap fills with fibrous tissue rather than bone;
    - anatomy:
           - in fetus, tibial tuberosity develops from anterior aspect of proximal epiphysis;
           - it subsequently develops its own growth plate and during childhood, it develops its own center of ossification;
           - this ossification center expands proximally and by age 17, it blends with ossification center of the tibial epiphysis;
    - diff dx:
           - avulsion of tibial tubercle:
                  - Osgood-Schlatter disease may be a risk factor for complete avulsion of the tibial tubercle;
           - jumper's knee;
           - Sindig-Larsen-Johanssen disease;

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- Clinical Manifestions:
    - local swelling and tenderness;
    - pain is aggravated by direct prssure of tibial prominence & jumping;

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- Radiographic Findings;
    - radiographs will not be helpful if injury occurs during preossification phase;
    - once the ossification center develops, radiographs will reveal radiodense fragments separated from tibial tuberosity;
    - fragmented appearance on radiography is due to partial separation of chondro-osseous fragments
    - in older teenagers, x-rays may show an ossicle in the substance of the tendon adjacent to the tubercle;

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- Non Operative Treatment:
    - avoidance of strenuous exercise and jumping sports;
    - some pts may require bracing or a sleeve cast;
    - expect complete resolution w/ in 1-2 yrs in most patients;

- Surgical Treatment: rarely necessary

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The so-called unresolved Osgood-Schlatter lesion: a concept based on fifteen surgically treated lesions.

Surgical treatment of unresolved Osgood-Schlatter lesion.

Osgood-Schlatter's disease in tibial tuberosity development.     

Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration.

Long-Term Outcome After Surgical Treatment of Unresolved Osgood-Schlatter Disease in Young Men Surgical Technique