Knee osteochondritis dissecans-treatment technical aspects

Purpose and objective: Current treatments of different stages of knee osteochondritis Dissecans (OCD) are depending on the age of the patients and the stability of the diseased osteochondral area. The purpose of this paper was to summarize the treatment alternatives in order to simplify the choice for the treating surgeon. Background and principle results: Osteochondritis dissecans (OCD) of the knee is an idiopathic and local osteo-chondral abnormality that affects mainly children and adolescents with risk of loosening of osteochondral fragments. A good clinical result can be expected when the physes are still open, when the osteochondritis is small and when the osteochondritis can be assessed as stable by MRI. Unstable OCD lesions most often need to be treated operatively by different fixation methods and when the osteochondral cannot be refixated, different local chondral and osteochondral repairs are available to fill up the defect area to congruity Summary and major conclusions: The final choice of which treatment to use is depending on fragment viability and forms. Viable fragments are refixated while poor quality fragments are removed followed by a local biological osteochondral repair. Such osteochondral resurfacing may be single bone marrow stimulation with or without scaffold augmentation or different cell seeded grafts.

Automated summary

This paper aims to summarize treatment alternatives for different stages of knee osteochondritis dissecans (OCD) based on patient age and the stability of the affected osteochondral area. Good clinical results can be expected when the patients are still growing, the osteochondritis is small, and the stability of the condition is confirmed by MRI. Unstable OCD lesions typically require operative treatment with fixation methods, and if refixation is not possible, various local chondral and osteochondral repairs are available. The final treatment choice depends on the viability and form of the fragments.