Drilling of Stable Symptomatic Juvenile OCD: Techniques and Outcomes

Osteochondritis dissecans (OCD) lesions in the skeletally immature patient are rare but have the potential to become debilitating if left untreated. For skeletally immature patients with stable OCD lesions who have failed nonoperative measures, drilling is often considered the gold standard for surgical treatment. The 3 main techniques of drilling include (1) trans-articular, (2) retro-articular, and (3) notch drilling, each of which have pertinent advantages and disadvantages which must be carefully considered based on the location and characteristics of the lesion, as well as surgeon experience and technical expertise. Outcomes of all 3 techniques show excellent results in patient reported outcome measures as well as very low complication and revision rates. To date, there are no high-level studies to date which have compared outcomes of each technique in prospective fashion.