This report reflects the evolution of the operative treatment of Osgood-Schlatter's disease as practiced in Our Lady's Hospital for Sick Children. In the earlier portion of the series patients were treated by drilling of the tibial tubercle with or without removal of the prominence (Group A--22 operations). In the latter portion of the series loose pieces of cartilage or bone were excised without removal of the prominent tubercle or drilling (Group B--22 operations). The results showed a much higher incidence of excellent or good results in Group B. These patients had a short simple operation followed by rapid mobilization and return to full activity. We would, therefore, recommend this procedure for those who have significant symptoms from osteochondritis of the tibial tubercle.