Editorial Commentary: Osteochondritis Dissecans of the Knee: The Great Confounder

The management of osteochondritis dissecans (OCD) continues to baffle even the savviest of surgeons, with unclear etiology, unknown relationship of presentation to outcome, bewildering response to various treatments, and frustratingly difficult-to-predict prognosis. Whether skeletal immaturity may be indicative of surgical success, at least when it comes to lesions requiring screw fixation, remains debatable. Treatment may include activity modification, drilling, fixation, or osteochondral replacement of OCD lesions in the knee. Regardless, each OCD lesion must be followed until osseous integration is confirmed by imaging -otherwise, progression of disease to osteoarthritis is likely.