Some osteochondral lesions are asymptomatic and may be incidentally found whilst imaging the knee for other reasons.  These can be typically managed non-operatively with monitoring as many will heal spontaneously.  Non-operative treatment may be indicated for some OCDs, and this may involve bracing, physiotherapy and medications.

Surgery for OCDs may involve either arthroscopic (keyhole) surgery or open surgery depending upon the type of lesion involved.  Surgical Options include:

• Removing the lesion (excision -if the lesion is detached and too small to fix)
• Drilling (if the lesion is stable)
• Fixing with screws/bone anchors/dissolving pins (for unstable lesions)
• Bone grafting – for chronic non-healing lesions
• Cartilage grafting from other areas of the knee
• Cartilage grafting from donated cartilage – rarely indicated
• Alignment correcting surgery – to take the pressure off osteochondral lesion.

There are many pros and cons of each surgical option, and Dr Slattery will discuss these options in greater detail with you depending upon your symptoms, imaging, and examination findings.

OCD Drilling procedure which is done minimally invasively

Cartilage Grafts (blue arrows) – “OATS” Procedure to fill the OCD