Management of loose osteochondritis dissecans in an adolescent.

Osteochondritis dissecans (OCD) of the knee joint affects subchondral bone first, and then it involves the articular cartilage. It can cause pain, effusion and loose body formation. Nonoperative treatment is for the stable lesion, but if the lesion is unstable and symptomatic, then operative management is needed. Short term goal of the treatment is pain relief, and the long-term goal is the prevention of early arthritis. Surgical treatment includes removal of loose body, microfractures, osteochondral autograft and allograft transplantation, autologous chondrocyte implantation (ACI), arthroscopic removal of the loose body and internal fixation of the fragment using k wire or screw. We successfully managed an adolescent with a loose OCD fragment with an arthroscopic evaluation, removal of the loose body and refixation of the loose fragment to the parent location, using three bio screws.