The Efficacy of Bracing in Nonoperative Care of Medial Femoral Condyle Osteochondritis Dissecans: A Study From the Research in Osteochondritis Dissecans of the Knee (ROCK) Study Group

BACKGROUND: Stable osteochondritis dissecans (OCD) lesions are primarily treated nonoperatively. Nonoperative treatment includes several recommendations, including the use of an unloader brace. However, little is known about the clinical effectiveness of unloader bracing and its influence on OCD healing, return to sports, and patient-reported outcomes (PROs). The purpose of this investigation was to evaluate the impact of unloader bracing on patients with stable medial femoral condyle (MFC) OCD lesions treated nonoperatively. PURPOSE: To investigate the influence of valgus unloader bracing on the success of treating stable MFC OCD with nonoperative treatment strategies. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The authors used a prospective cohort of patients receiving nonoperative care for stable MFC knee OCD lesions. The primary variable of interest was the efficacy of bracing. The primary outcomes were transition from nonoperative care to surgical intervention, return-to-play (RTP) clearance, and PROs. Bivariate testing was used to determine if there were differences between groups. Chi-square testing was used to determine if there were differences in rates of transition to surgery by group. The timing of the transition by each group was assessed using a Wilcoxon rank-sum test, given the nonparametric nature of the data. Kaplan-Meier survival analysis was used to calculate time at risk, incidence rate, and survival times for each group. RESULTS: = .693). PRO scores were similar between the 2 groups at the time of RTP clearance. CONCLUSION: The inclusion of an unloader brace in the nonoperative treatment for stable MFC OCD lesions did not decrease the likelihood of patients undergoing surgical intervention or improve their PRO scores at the time of RTP clearance. REGISTRATION: NCT02771496 (ClinicalTrials.gov identifier).

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Journal
The American Journal of Sports Medicine
Published
2026-04-14
DOI
https://doi.org/10.1177/03635465261429407
Primary Topic
Osteoarthritis Treatment and Mechanisms
Type
article
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article

The Efficacy of Bracing in Nonoperative Care of Medial Femoral Condyle Osteochondritis Dissecans: A Study From the Research in Osteochondritis Dissecans of the Knee (ROCK) Study Group

Paul M. Saluan, Jennifer M. Weiss, Daniel W. Green, John B. Erickson et al.
The American Journal of Sports Medicine
Osteoarthritis Treatment and Mechanisms
article

The Efficacy of Bracing in Nonoperative Care of Medial Femoral Condyle Osteochondritis Dissecans: A Study From the Research in Osteochondritis Dissecans of the Knee (ROCK) Study Group

Paul M. Saluan, Jennifer M. Weiss, Daniel W. Green, John B. Erickson, Peter D. Fabricant, Benton E. Heyworth, Sasha Carsen, Eric W. Edmonds, Kevin Latz, Christian Noel Anderson, Crystal A. Perkins, James L. Carey, Aaron John Krych, Jutta Ellermann, Cathy Carlson, Marc Tompkins, Jay C. Albright, Nathan L. Grimm, Jonathan Godin, Mark V. Paterno, Rick W. Wright, Regina O. Kostyun, Jie C. Nguyen, Allison Crepeau, Carl W. Nissen, J. Lee Pace, Henry B. Ellis, Samuel Clifton Willimon, Pat Riley, Andrew T. Pennock, Henry G. Chambers, Theodore John Ganley, Philip L. Wilson, James Hui Hoi Po, Eric J. Wall, Dustin M. Loveland, John D. Polousky, Jeffrey J. Nepple, Matthew D. Milewski, The ROCK Group, Bradley J. Nelson, Roger M. Lyon, Ryan Koehler, Mininder S. Kocher, Norbert M. Meenen, Gregory D. Myer, Kevin G. Shea, Michael T. Busch
article en

Abstract

BACKGROUND: Stable osteochondritis dissecans (OCD) lesions are primarily treated nonoperatively. Nonoperative treatment includes several recommendations, including the use of an unloader brace. However, little is known about the clinical effectiveness of unloader bracing and its influence on OCD healing, return to sports, and patient-reported outcomes (PROs). The purpose of this investigation was to evaluate the impact of unloader bracing on patients with stable medial femoral condyle (MFC) OCD lesions treated nonoperatively. PURPOSE: To investigate the influence of valgus unloader bracing on the success of treating stable MFC OCD with nonoperative treatment strategies. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The authors used a prospective cohort of patients receiving nonoperative care for stable MFC knee OCD lesions. The primary variable of interest was the efficacy of bracing. The primary outcomes were transition from nonoperative care to surgical intervention, return-to-play (RTP) clearance, and PROs. Bivariate testing was used to determine if there were differences between groups. Chi-square testing was used to determine if there were differences in rates of transition to surgery by group. The timing of the transition by each group was assessed using a Wilcoxon rank-sum test, given the nonparametric nature of the data. Kaplan-Meier survival analysis was used to calculate time at risk, incidence rate, and survival times for each group. RESULTS: = .693). PRO scores were similar between the 2 groups at the time of RTP clearance. CONCLUSION: The inclusion of an unloader brace in the nonoperative treatment for stable MFC OCD lesions did not decrease the likelihood of patients undergoing surgical intervention or improve their PRO scores at the time of RTP clearance. REGISTRATION: NCT02771496 (ClinicalTrials.gov identifier).

The American Journal of Sports MedicineVol. 54(6)
Children's Hospital of Wisconsin (US), Hospital for Special Surgery (US), Cincinnati Children's Hospital Medical Center (US), Boston Children's Hospital (US), Hartford Hospital (US), University of Minnesota (US), Cleveland Clinic (US), Children's Mercy Hospital (US), Emory Healthcare (US), Mayo Clinic (US), Lucile Packard Children's Hospital (US), Children's Hospital of Philadelphia (US), Emory University (US), National University of Singapore (SG), Washington University in St. Louis (US), Children's Hospital of Eastern Ontario (CA), Texas Scottish Rite Hospital for Children (US), Rady Children's Hospital-San Diego (US), Tennessee Orthopaedic Alliance (US), Children's Hospital Colorado (US), Minnesota Orthopedic Sports Medicine Institute (US), Akron Children's Hospital (US), Gillette Children's Specialty Healthcare (US), Connecticut Children's Medical Center (US), Proteogenomics Research Institute for Systems Medicine (US), Steadman Clinic (US), Andrews Institute for Orthopaedics & Sports Medicine (US), Asklepios Klinik St. Georg (DE), TRIA Orthopaedic Center (US), Shriners Hospitals for Children (US), Children's Healthcare of Atlanta (US), Hartford Financial Services (United States), UConn Health (US), University of Pennsylvania (US), Vanderbilt University Medical Center (US), University of Cincinnati Medical Center (US), University of Colorado Denver (US)
Openalex Percentile: Top 27%
Osteoarthritis Treatment and Mechanisms
DOISourceOpenAlex
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