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
mortarmens knee
Adult onset tibial tubercle exostosis

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.


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