Juvenile osteochondritis dissecans

Sports Med Arthrosc Rev. 2011 Mar;19(1):56-63. doi: 10.1097/JSA.0b013e31820b94b9.


Juvenile osteochondritis dissecans (JOCD) has been a recognized entity for more than 100 years. Despite our long recognition of OCD, the natural history and most effective therapies are poorly understood. Although conclusive evidence of an exact cause is lacking, there is widespread agreement that JOCD is related to repetitive trauma. Patients with JOCD present with vague pain and occasionally, mechanical symptoms. The diagnosis of JOCD can be confirmed on plain radiographs. Magnetic resonance imaging has emerged as the study of choice to evaluate the stability of the lesion and integrity of the overlying articular cartilage. Treatment decisions are based on the stability of the lesion. Stable JOCD lesions should be treated initially with activity modification and possibly, immobilization. Unstable lesions and stable lesions not responding to an initial course of nonoperative therapy should be surgically treated. Surgical treatment is based on the radiographic and arthroscopic characteristics of the lesion. Multiple techniques from simple arthroscopic drilling and fixation to salvage techniques for cartilage restoration are discussed.

Publication types

  • Review

MeSH terms

  • Absorbable Implants
  • Adolescent
  • Arthroscopy
  • Athletic Injuries* / diagnosis
  • Athletic Injuries* / diagnostic imaging
  • Athletic Injuries* / etiology
  • Athletic Injuries* / therapy
  • Bone Screws
  • Bone Transplantation
  • Child
  • Cumulative Trauma Disorders / diagnosis
  • Cumulative Trauma Disorders / diagnostic imaging
  • Cumulative Trauma Disorders / etiology
  • Cumulative Trauma Disorders / therapy
  • Diagnosis, Differential
  • Fracture Fixation
  • Humans
  • Knee / diagnostic imaging
  • Knee / physiopathology
  • Magnetic Resonance Imaging
  • Musculoskeletal Development / physiology
  • Ossification, Heterotopic / diagnosis
  • Ossification, Heterotopic / etiology
  • Osteochondritis Dissecans* / diagnosis
  • Osteochondritis Dissecans* / diagnostic imaging
  • Osteochondritis Dissecans* / etiology
  • Osteochondritis Dissecans* / therapy
  • Radionuclide Imaging
  • Salvage Therapy
  • Sports / physiology