Current review of juvenile osteochondritis dissecans of the knee

Abstract

Juvenile osteochondritis dissecans (OCD) is a common source of knee pain in the skeletally immature patient. The etiology of this common lesion is still not agreed upon, but is thought to represent repetitive microtrauma to a focal area in the knee. It can be present anywhere in the knee, but usually is found in the lateral aspect of the medial femoral condyle. It most commonly presents with pain, activity limitation, and occasional swelling. In severe cases, mechanical symptoms may be present as well. Multiple classification systems have been described. Broadly, these lesions can be graded as stable or unstable based on the level of subchondral bone involvement and the integrity of the overlying cartilage. The majority of these lesions can initially be treated nonoperatively. Surgery may be indicated with either progression of symptoms in stable lesions or with unstable lesions. Many operative procedures have shown good results. This review describes the etiology, incidence, diagnosis, imaging modalities, classification, nonoperative, and operative management of juvenile OCD lesions of the knee with a focus on the most recent literature.