Outcomes of arthroscopic management in knee osteochondritis dissecans: a systematic review and single-arm meta-analysis

Abstract Background This single-arm meta-analysis investigated the efficacy of arthroscopic drilling and or fixation as surgical management of osteochondritis dissecans (OCD). Methods A literature search of PubMed, EMBASE (Elsevier), CiNHAL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus and Web of Science was conducted from database inception to 23rd September 2025 (PROSPERO ID: CRD42023423178). Results Nineteen studies met the eligibility criteria, including 530 patients and 569 knees. The mean preoperative Lysholm scores were 66.09 (95% Cl: 58.63, 73.56, I 2 = 99%) and were 94.26 (95% Cl: 90.76, 97.76, I 2 = 78%) 5 years onwards postoperatively. The mean preoperative International Knee Documentation (IKDC) scores were 50.31 (95% Cl: 43.16, 57.45, I 2 = 96%) and were 90.86 (95% Cl: 85.71, 96.01, I 2 = 99%) 24 months and onwards postoperatively. Minimal clinically important difference (MCID) was achieved for all Lysholm and IKDC score follow-up points. Hughston rating scale 24 months and onwards postoperatively saw 96% achieve excellent or good ratings (95% CI: 0.92, 1.00, I 2 = 0%), with 4% achieving fair or poor (95% CI: -0.00, 0.08, I 2 = 0%). Evidence of healing success via radiographic imaging was 87.6% (95% CI: 0.82, 0.94, I 2 = 76%). Evidence of healing success via magnetic resonance imaging (MRI) was 93.6% (95% CI: 0.89, 0.98, I 2 = 0%). Patients returning to performing their daily activities post-operation were 92.8% (95% CI: 0.88, 0.98, I 2 = 62%). Further surgery following initial arthroscopy was 5.9% (95% CI: 0.04, 0.08, I 2 = 0%). Conclusion Arthroscopic drilling and or fixation in the treatment of OCD is associated with reduced pain and improved functionality, including return to regular activities.