Mortarmen’s knee

Synonym: Adult onset tibial tubercle exostoses

History:

• Pain over anterior surface of upper tibia
• Pain during running, jumping, squatting, kneeling and descending stairs
• Usually no history of trauma, anterior knee pain or Osgood-Schlatter disease

Physical examination:

• Tenderness over hypertrophic tibial tubercle
• Quadriceps tightness (Ely’s test)

X-rays:

• AP, lateral and tangential patellofemoral joint views of knee
• Exostosis and fragmentation, with multiple ossicles of tibial tubercle

Management:

a. Conservative:

• Optimal loading
• Eccentric focused quadriceps strengthening and stretching
• NSAIDs as required
• Silicon knee pads

b. Surgical: May require excision (not reported till date)

Reference: Fraser JJ, Frantz EA. Mortarmen’s Knee: Adult-Onset Tibial Tubercle Exostoses in 2 Infantrymen. J Orthop Sports Phys Ther. 2018 Jun;48(6):510. doi: 10.2519/jospt.2018.8005. PMID: 29852835.

Dr. Sulabh Kumar Shrestha, MS Orthopedics

He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music.