{'fraction_non_alphanumeric': 0.01988781234064253, 'fraction_numerical': 0.0005099439061703213, 'mean_word_length': 5.475247524752476, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Management of Osteochondritis Dissecans of the Knee

The primary goals of treatment of osteochondritis dissecans (OCD) of the knee are healing of the subchondral bone, preservation of the articular cartilage, and, ultimately, prevention of arthritis. The methods used to accomplish these goals depend on the pathologic changes of the lesion and the healing capacity of the patient. The skeletally immature knee has a greater capacity for healing; consequently, nondisplaced lesions with intact articular cartilage in children and adolescents may be treated conservatively. This method of treatment should be abandoned in patients who show no signs of healing after 6 months or in those approaching skeletal maturity. The generally accepted principles of surgical treatment of OCD are to improve blood flow to the fragment, provide bony support if necessary to reestablish congruency, and stabilize loose or separated fragments. The type of surgical treatment depends on many factors, including the age of the patient, stage of the lesion, and preference of the surgeon. Arthroscopic drilling is a relatively reliable procedure in adolescents with a stable lesion who are skeletally immature (juvenile osteochondritis dissecans, JOCD). Adult osteochondritis dissecans (AOCD) is less likely to heal with drilling, and, therefore, a more aggressive surgical procedure is indicated. Retrograde bone grafting and drilling may be performed for AOCD with a stable fragment with good subchondral support. Revascularization and stabilization of the fragment is the procedure of choice for JOCD or AOCD patients with loose or separated fragments. Replacement and stabilization of the lesion may not be possible if the articular cartilage has completely deteriorated. Although excision of the fragment is easier, and the short-term results are good, long-term results of excision are extremely poor. Consequently, resurfacing should be performed in preference to excision.