Arthroscopic management of refractory Osgood–Schlatter disease: a case series and surgical technique

Osgood-Schlatter disease (OSD) is a self-limiting traction apophysitis in adolescents. While most resolve with conservative care, a subset of skeletally mature athletes may develop chronic anterior knee pain from persistent ossicles. Surgical excision is considered when nonoperative measures fail. This study aims to report outcomes of unresolved OSD treated with arthroscopic tibial ossicle excision. Three male patients, aged 34, 45, and 51, presented with anterior knee pain persisting for over one year despite standard non-surgical treatments. Imaging confirmed tibial ossicles. Arthroscopic removal was performed using anteromedial and anterolateral portals under fluoroscopic guidance. All surgeries were uneventful. Patients ambulated immediately postoperatively and returned to sports within 4-5 weeks. At 6-month follow-up, they were pain-free, could kneel comfortably, had full range of motion, and no tibial tubercle tenderness. No complications occurred. Arthroscopic excision is a safe, minimally invasive alternative to open surgery, allowing early recovery and return to sport.