Bilateral knee osteochondritis dissecans: early diagnosis, surgical treatment and successful return to sport

Osteochondritis dissecans (OCD) is a rare joint disorder primarily affecting adolescent athletes, potentially requiring surgical intervention, particularly in cases of bilateral lesions. This report presents an adolescent professional football player with ICRS IV OCD lesions in both knees, treated surgically with debridement, microfracture and fixation. 3 years after the initial surgery on the right knee, a similar lesion developed in the left knee, requiring identical treatment. The patient achieved a complete recovery, attaining a perfect Lysholm score of 100 and successfully returning to elite-level football. This case highlights the challenges of diagnosing and treating bilateral OCD in athletes. It underlines the possible gain of early bilateral imaging in high-risk individuals and the effectiveness of surgical intervention for unstable lesions. Further research is needed to establish optimised treatment protocols for bilateral OCD, particularly in athletic populations at risk for recurrent lesions and joint deterioration.