All-Arthroscopic Bone Grafting and Primary Fixation of a Medial Femoral Condyle Osteochondritis Dissecans Lesion

Treatment of osteochondritis dissecans (OCD) lesions poses a significant challenge for orthopaedic surgeons and can cause debilitating limitations on the activity of patients. Timing of intervention, surgical technique, and selection of graft when needed are all key elements of treatment that need to be considered carefully and discussed with patients. Primary fixation of an OCD fragment with intact subchondral bone has been shown to be beneficial in some cases. There is limited literature, however, on how to approach large chondral lesions in young patients without a large subchondral base attached to the fragment. Treatment of large OCD lesions of the knee with an all-arthroscopic approach provides several benefits, including limited dissection for exposure, improved ability to assess the stability of the OCD lesion during articulation after fixation, and an expedited recovery compared to an open approach. The purpose of this technical note is to detail a technique of performing an all-arthroscopic bone grafting and primary fixation of a medial femoral condyle OCD lesion.