Osteochondritis Dissecans (OCD) Treatment

⚙️What This Procedure Involves

Arthroscopic drilling: for stable lesions, multiple small holes are drilled through the intact cartilage into the underlying bone to stimulate a healing blood supply. Fixation: for unstable lesions, the fragment is reduced (replaced) and fixed with bioabsorbable pins, headless screws, or fibrin glue. Fragment removal and microfracture: if the fragment is non-viable, it is removed and the defect is treated with microfracture, OATS, ACI, or osteochondral allograft depending on size. The operation takes 45–90 minutes.

💡Why It May Be Recommended

Surgery is recommended for OCD lesions that are unstable (loose or detaching), causing mechanical symptoms, or have not healed with activity modification and observation. In children with open growth plates, stable lesions may be observed initially.

⚖️Non-Operative Alternatives

Activity modification and restricted weight-bearing for stable lesions, particularly in children with open growth plates. Observation with serial MRI to monitor healing. Non-operative management is successful in approximately 50% of juvenile OCD cases.

📋Preparing for Surgery

MRI to assess lesion stability and size. X-rays including tunnel view. Arthroscopy may be diagnostic and therapeutic.

✅Expected Benefits

For stable lesions treated with drilling: healing rates approximately 80–90% in juveniles. For unstable lesions fixed in situ: healing rates approximately 70–85%. For fragment removal with cartilage restoration: outcomes depend on defect size and chosen technique.

⚠️Common Risks

• Persistent symptomsUncommon

  Ongoing knee pain despite treatment.

• SwellingExpected

  Knee swelling during healing.

• StiffnessCommon

  Temporary loss of full range.

🔴Less Common but Serious Risks

• Fragment non-healingUncommon

  The fixed fragment may not heal and may detach again.

• Progression to arthritisLong-term

  If the joint surface is damaged significantly.

• InfectionRare

  Joint infection.

• Blood clotsUncommon

  With restricted weight-bearing.

💉Anaesthetic Considerations

General or spinal anaesthesia.

🏃Recovery and Rehabilitation

Weight-bearing restrictions for six to eight weeks (depending on the procedure). Physiotherapy for range of motion and strengthening. Running at three to four months. Return to sport at four to six months. MRI to confirm healing.

📅Follow-Up

MRI at three and six months to assess healing. X-rays. Long-term monitoring.

❓Frequently Asked Questions