Juvenile Osteochondritis Dissecans: Current Concepts

Abstract

Osteochondritis dissecans (OCD) primarily damages the subchondral bone, leading to damage to the articular cartilage. Juvenile OCD (JOCD) of the knee is limited to skeletally immature and young patients with open growth plates on radiographs. We conducted a review of PubMed articles up until March 16, 2024, using a combination of the following keywords: knee, juvenile, and osteochondritis dissecans. This narrative review included a total of 56 relevant articles that investigated the etiology, incidence, clinical presentation, imaging, classification, and treatment of JOCD of the knee in patients less than 20 years of age. The exact etiology is controversial. Most authors believe that the disease involves multiple theories, such as ischemia, recurrent trauma, and genetic predisposition. Radiographs, the first imaging study in this patient group, cannot determine the stability or instability of the surface cartilage of the OCD lesion. As a result, MRI has become a recommended diagnostic method for determining OCD stability and providing important information for determining a treatment plan. For stable JOCD lesions, nonsurgical treatment is often advised. For unstable and stable lesions that do not respond to nonsurgical treatment, several surgical techniques with good healing rates are available.

Keywords: autologous adipose-derived mesenchymal stem cell implantation; autologous chondrocyte implantation; autologous osteochondral transfer; drilling; juvenile osteochondritis dissecans; microfracture.