Treatment of multiple chondral/osteochondral lesions in the knee of a juvenile athlete: A case report with literature review

Chondral and osteochondral lesions in the knee, particularly in juvenile athletes, pose significant challenges due to their impact on joint functionality and the complexity of treatment. This case report describes the management of a 14-year-old soccer athlete with osteochondritis dissecans of the lateral femoral condyle and a subsequent grade IV chondral lesion in the femoral trochlea. The initial treatment with fresh osteochondral transplantation resulted in osteointegration, pain resolution, and restored functionality. During rehabilitation, a secondary trochlear lesion developed and was treated with a combination of micro-fragmented autologous adipose tissue and a collagen membrane. The patient showed significant improvements in functional scores (Internation Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and Lysholm) and magnetic resonance imaging-confirmed cartilage regeneration and returned to sports-specific training. These findings highlight the potential of regenerative techniques for cartilage repair in young athletes. Further research is needed to validate these results in larger cohorts with extended follow-ups.