OrthoNet

OCD
Approach to Osteochondritis Dissecans

Principles of Treatment
- age is a huge factor - before or after 12 is a big deal. You look at these patient populations kinda differently
- size of fragment is important
- stability of fragment is important - can be assessed on MRI.

In the Patient 12 Years of Age
- in this population, you are leaning to fix the lesion. They do not heal as well with the conservative approach. MRI on almost all of these.
- MRI: is the cartilage intact? Is there fluid behind? Is the piece unstable? Has the piece displaced completely already?
- if symptomatic and stable - lean towards scoping and drilling
- if symptomatic and unstable - be prepared to scope then open the thing up, even take the lesion out, bone graft the base, and fix it.