Unresolved Osgood-Schlatter disease in a skeletally mature female managed with bursoscopic debridement.

Introduction and importance: Osgood-Schlatter disease is one of the common causes of knee pain among sports-practicing adolescents. It usually presents in skeletally immature adolescent males with unilateral knee pain. The disease is often self-imiting and managed conservatively. Case presentation: We report a case of a female in her early 20s who presented with pain over the tibial tuberosity in the right knee for 6 years, with no history of involvement in any sports-related activities. The diagnosis was made based on the MRI of the right knee, which showed abnormal signal intensity in the tibial tuberosity. After conservative management for about 1 year, the patient underwent bursoscopic debridement of ossicles and tibial tuberosity. The WOMAC score at follow-up of 1 year and 2 years was 1/96 and 0/96, respectively. Clinical discussion: Osgood-Schlatter disease is common in adolescents involved in sports-related activities, with earlier onset in females due to earlier bone maturation. Presentation in skeletally mature females and without a history of sports-related activities is rare. Usually, 90% of the cases improve with conservative management; however, surgical debridement was required in our case. Conclusion: Osgood-Schlatter disease should be considered a differential diagnosis for anterior knee pain in a young adult. Bursoscopic debridement can be performed in patients with persistent knee pain that is unresponsive to medical management.