Osteochondritis Dissecans of the Knee: Treatment of Juvenile and Adult Forms

Osteochondritis dissecans (OCD) and juvenile osteochondritis dissecans (JOCD) are distinct entities that require different management. Although both conditions result from stress fractures of the subchondral bone, JOCD has a much better prog-nosis; treated conservatively, 50% of cases will heal, probably providing a normal knee during adult life. In contrast, OCD often is followed by the early onset of degenerative arthritis. The treatment of JOCD and OCD, whether nonoperative or operative, should be based on the principles of fracture treatment. Unfortunately, surgical correction of either of these conditions is unlikely to succeed unless the joint surface is perfectly restored.