A Review of Current Treatments of Knee Osteochondral Defects in High-Level Athletes

Osteochondral defects (OCDs) represent a major concern for high-level running and jumping athletes, often leading to significant knee injuries. If left untreated, large OCDs can progress to osteoarthritis, making it imperative for effective repair to restore the knee to its pre-injury state. This article offers a comprehensive review of osteochondral defects, including their etiology, specifically how different injury mechanisms contribute to their development. It also delves into the classification of the defect and categorization by the extent, depth, size, and location of the defect. While surgical intervention is often the best approach for managing most OCD lesions and optimizing patient outcomes, the surgeon must consider the patient’s individual goals. One must evaluate the cost-effectiveness of surgery, anticipated rehabilitation and recovery time, and the patient's desired postoperative activity level. Evidence suggests that small, favorably located, and early-diagnosed defects respond best to early treatment. Despite various treatment approaches, there is currently no “gold standard” surgical technique, which remains an active area of ongoing research and debate. Further research should focus on identifying the optimal surgical procedure for patients who aim to return to high-level athletic activity after their injury.