This protocol addresses skeletally mature patients who present with hip fracture in the setting of osteochondritis dissecans (OCD) of the knee with an unstable or displaced lesion. These patients are symptomatic — with knee pain, swelling, locking, catching, popping, or giving way — and may show physical signs such as tenderness, effusion, loss of motion, or crepitus.
Skeletally mature patients with OCD lesions who have signs of instability, loosening, or displacement — often confirmed on imaging — are unlikely to heal without active intervention. Clinical evidence supports offering surgery to symptomatic patients in this group. Conservative management alone is generally insufficient once the lesion is unstable or displaced.
The approach involves an arthroscopic surgical procedure directed at the OCD lesion of the knee. The complete technique, sequencing, and post-operative plan are covered in the full structured regimen.
Full protocol details — including specific steps and follow-up criteria — are available via the link below.The target outcome is meaningful, sustained improvement in knee pain, knee symptoms, and overall knee physical function, assessed at 48 months using validated outcome measures.
Symptomatic skeletally mature patients with unstable or displaced OCD lesions be offered the option of surgery.
Skeletally mature patients with OCD lesions who have a history of not healing and/or have signs of loosening (usually detected by MRI) are unlikely to heal without treatment.
One Level IV study (n = 15) reported the Tegner activity, Lysholm, Knee Outcome and Osteoarthritis Symptom and Sport (KOOS) and the SF-12 Mental and Physical scores of patients treated with arthroscopic reduction and internal fixation (ARIF).
At 48 months, patients treated with ARIF had statistically significantly improvements from baseline measured by the Lysholm, International Knee Documentation Committee, Short form-12 (SF-12) Physical, and Knee injury and Osteoarthritis Outcome (KOOS) scores.
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