Will my child's knee OCD heal with rest, without surgery?

Who is suited to non-surgical treatment

• Growth plates still open on X-ray
• A stable lesion, with intact cartilage and no fluid tracking behind the fragment on MRI
• No locking, catching or loose fragment
• Symptoms that settle with reduced activity

Lesions that are large, unstable, or in teenagers close to the end of growth are less likely to heal this way.

What the treatment involves

The core of treatment is removing the repetitive impact that stops the bone from healing. This usually means no running, jumping or competitive sport for a period, typically at least three to six months. Depending on symptoms, some children use crutches for a few weeks or a brace. Walking for daily life, swimming and gentle cycling are often allowed once pain settles. Physiotherapy keeps the thigh and hip muscles strong and the knee moving.

How healing is checked

Follow-up X-rays, and often a repeat MRI, are done every few months to see whether the bone is filling in. Healing can be slow and is sometimes incomplete even when the child feels well. Returning to sport because the pain has gone, before the scans show healing, is one of the commonest reasons for setbacks.

When the plan changes

Surgery is usually considered if the lesion has not healed after several months of well-followed rest, if it becomes unstable on scans, or if the knee starts to lock or catch. Dr. Gelber reviews progress at Aman Hospital in Doha and discusses with the family when it is time to change approach.