Incarcerated pes anserinus around a proximal tibial osteochondroma: a rare extra-articular Cause of locked knee

Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 78-80 | Sachin Khemkar, Eknath Pawar, Vipul Shet, Mrinal Kambli, Nihar Modi, Mitali Mokashi

DOI: 10.13107/jcorth.2022.v07i02.539

Author: Sachin Khemkar [1], Eknath Pawar [1], Vipul Shet [1], Mrinal Kambli [1], Nihar Modi [1], Mitali Mokashi [1]

[1] Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Sachin Khemkar,
Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.


Background: Osteochondroma is the most common benign skeletal neoplasm and is found most often in long bones, especially in the distal femur and proximal tibia. They usually present as painless swelling near the joint and can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and post-operative recurrence. Locking of the knee refers to flexion of the knee without complete extension and passive extension is limited resulting in significant pain. Excision is a successful form of the treatment for symptomatic osteochondromas.

Case Report: A case of osteochondroma of the proximal tibia illustrates extra-articular cause of locked knee secondary to the incarceration of pes anserinus tendons by the lesion.

Conclusion: Surgical excision of the bilobed pedunculated posteromedial proximal tibia osteochondroma and restoration of the gracilis and semitendinosis to its normal anatomic position resulted in the complete resolution of symptoms.

Keywords: Osteochondroma, Locked knee, Pes anserinus


  1. Oh JY, Tan KK, Wong YS. “Snapping” knee secondary to a tibial osteochondroma. Knee 2008;15:58-60.
  2. Woertler K, Lindner N, Gosheger G, Brinkschmidt C, Heindel W. Osteochondroma: MR imaging of tumor-related complications. Eur Radiol 2000;10:832-40.
  3. Andrews K, Rowland A, Tank J. Knee locked in flexion: Incarcerated semitendinosus tendon around a proximal tibial osteochondroma. J Surg Case Rep 2019;2019:rjy346.
  4. Bansal P, Deehan DJ, Gregory RJ. Diagnosing the acutely locked knee. Injury 2002;33:495-8. .
  5. Florez B, Mönckeberg J, Castillo G, Beguiristain J. Solitary osteochondroma long-term follow-up. J Pediatr Orthop B 2008;17:91-4.
  6. Heck RK Jr., Toy PC. Benign bone tumors and nonneoplastic conditions simulating bone tumors. In: Azar FM, Beaty JH,. editors. Campbell’s Operative Orthopaedics. 14th ed., Vol. 25. Philadelphia, PA: Elsevier; 2021. p. 965-7.
  7. Holt GE. Orthopaedic pathology. In: Miller MD, Thompson SR, editors. Miller’s Review of Orthopaedics. 8th ed., Vol. 9. Philadelphia, PA: Elsevier; 2020. p. 2663-6.
  8. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: Variants and complications with radiologic-pathologic correlation. Radiographics 2000;20:1407-34.
  9. Cañete M, Fontoira E, Jose BG, Mancheva S. Osteochondroma: Radiological diagnosis, complications and variants. Rev Chil Aust Radiol 2013;19:73-81.
  10. Espejo-Baena A, Coretti SM, Fernandez JM, Garcia-Herrera JM, Del Pino JR. Knee locking due to a single gouty tophus. J Rheumatol 2006;33:193-5.


How to Cite this article: Khemkar S, Pawar E, Shet V, Kambli M, Modi N, Mokashi M. Incarcerated Pes Anserinus Around a Proximal Tibial Osteochondroma: A Rare Extra-articular Cause of Locked Knee. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):78-80.

 (Abstract    Full Text HTML)   (Download PDF)