Arthroscopic Herbert screw fixation of patellar osteochondritis dissecans

Osteochondritis dissecans of the patella is a rare cause of anterior knee pain. The lesion is thought to arise from chronic shear stress across the patella articular surface, producing a fragment of cartilage and subchondral bone that may remain in situ or become detached. When attempts at conservative treatment fail to provide satisfactory results, operative intervention is indicated. We present the case of a symptomatic lesion of the patella treated successfully with arthroscopic internal fixation using a retrogradely directed Herbert screw. The literature is reviewed with an emphasis on pathophysiology, diagnosis, and surgical treatment.