How should a stable osteochondritis dissecans (OCD) lesion in skeletally immature athletes be managed?

The management of a stable osteochondritis dissecans (OCD) lesion in skeletally immature athletes involves a conservative approach, particularly with the option of offloading and immobilizing the affected area. This strategy allows for relief from mechanical stress on the lesion, which is crucial in young athletes as their bones are still developing and may be more susceptible to injury.

Offloading the area helps to minimize pain and prevent further damage to the cartilage or the underlying bone, allowing the injury to heal naturally over time. This conservative management is particularly effective when the lesion is stable, meaning that there is no displacement of the bone fragment. Immobilization supports the healing process by restricting movement that could exacerbate the injury, while also providing a chance for potential revascularization and regeneration of cartilage.

Engaging in rehabilitation with strengthening exercises, while beneficial for overall conditioning, should usually take place after initial offloading. It's essential to allow the lesion to stabilize before introducing any weight-bearing or strengthening activities, which could risk exacerbating the condition if the injury has not yet sufficiently healed. Consequently, this method prioritizes the health and development of the young athlete's skeletal system.