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)

Ely’s test

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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.