Knee Osteochondritis Dissecans Follow-up

Updated: Apr 28, 2017
  • Author: Brian A Jacobs, MD, FACSM; Chief Editor: Craig C Young, MD  more...
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Follow-up

Return to Play

Return to play is allowed once the OCD lesion has healed and quadriceps strength has returned to within normal limits. If the athlete was treated surgically, he or she may return to play when the OCD lesion has healed and any obstructive retained hardware has been removed.

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Complications

A nonunion of the OCD fragment may occur and progress to dissociation, leading to intra-articular loose body symptoms. This, in turn, may lead to a type of reconstructive procedure such as OATS or ACI (see Surgical Intervention in Acute Phase). Regardless of treatment, degenerative articular changes may develop over time.

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Prognosis

The general rule for the prognosis of OCD is the younger the patient, the better the prognosis. The prognosis also depends on the size and severity of the lesion.

A study by Nakayama et al examined 37 patients to understand factors affecting the prognosis of conservative treatment for stable juvenile osteochondritis dissecans of the lateral femoral condyle. The study found that 32.6% of the 43 knees studied had no signs of radiologic healing at 6 month follow-up. A discoid meniscus was identified in all of these knees with no healing. Another risk factor for poor non-opertative healing was a time period ≥ 6 months from onset to consultation. [11]

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