According to a study published online in The American Journal of Sports Medicine, patients with osteochondritis dissecans (OCD) who are treated with fragment excision may be at greater risk of osteoarthritis (OA) and arthroplasty than those treated with fragment preservation or chondral defect grafting. 

The researchers conducted a cohort study of 221 OCD patients with mean 16.3-year follow-up. Overall, 134 patients were treated with fragment excision, 78 with fragment preservation, and nine with chondral defect grafting. The researchers found that the cumulative incidence of OA in the fragment excision group was 12.0 percent at 5 years, 17.0 percent at 10 years, 26.0 percent at 15 years, 39.0 percent at 20 years, and 70 percent at 30 years. In comparison, the cumulative incidence of OA in the fragment preservation group was 3.0 percent at 5 years, 7.0 percent at 10 years, 16.0 percent at 15 years, 25.0 percent at 20 years, and 51 percent at 30 years. In addition, patients in the fragment excision cohort were significantly more likely to undergo arthroplasty compared to those in the fragment preservation cohort. No patients in the chondral defect grafting group had developed OA or undergone arthroplasty at most recent follow-up. Learn more...