Advances in Surgical Treatment of Osteochondritis Dissecans of the Knee

Osteochondritis dissections of the knee is a challenging condition to treat in both skeletally-immature and mature individuals. Guiding treatment principles are the improvement of both the biology and stability of the lesion. Advances in both imaging and arthroscopic assessment have aided surgeons in the treatment of these aspects of osteochondritis lesions. However, level of evidence for best treatment remains low overall. Both arthroscopic and open techniques may be utilized to treat these lesions. Subchondral drilling, injection of bone marrow aspirate concentrate, and debridement with retro-articular or open bone grafting have all been described as methods of biologic augmentation. Bioabsorbable and metallic implants traversing the progeny and parent aspects of the lesion, as well as surface compressive suture fixation may be appropriate techniques for augmenting lesion stability. These techniques are further described with recognition that further study regarding indications and outcomes remains ongoing.