The treatment of an osteochondral lesion is based on the stability of the lesion. Lesions can be stable or unstable.
A Stable lesion means that the cartilage overlying the bone is not damaged and the lesion is not likely to be lose. For stable lesions, non-operative management is usually the first step including:
- Activity modification – avoiding twisting and heavy contact activities
- Pain relief
Surgery may be needed in stable osteochondral lesion’s that have a failed to improve despite a prolonged period of non-operative management. If the lesion is considered stable but large, surgery may also be indicated.
An Unstable lesion means the cartilage and bone are both broken and, in some instances, the lesion can break away from the original donor site and become a loose fragment moving freely within the joint. Surgery is nearly always be recommended if the OCL has broken free and is loose inside the joint.