The purpose of this study is to compare the functional, clinical and radiographic outcomes associated with trans-articular drilling versus retro-articular drilling, two commonly employed techniques of operative treatment for stable forms of juvenile osteochondritis dissecans (JOCD) lesions. This study also aims to better define the natural history of this condition in its most commonly identified pathological state (as a stable lesion) following surgical intervention by determining the rate of radiographic healing and any need for secondary surgery.

Inclusion Criteria:

• Diagnosis of JOCD,
• Lesion located on the lateral aspect of the medial femoral condyle,
• Lesion considered stable based on MRI,
• Patient deemed skeletally immature based on MRI,
• Completed a course of conservative therapy.

Exclusion Criteria:

• Significant concomitant knee pathology (AVN, fracture, inflammatory arthritis, ACL tear, discoid/meniscal tear, etc.)
• Lesion healed sufficiently and surgery is not recommended,
• Prior surgery on the affected knee,
• Diagnosis of metabolic bone disorder (e.g. osteogenesis imperfecta),
• Diagnosis of sickle cell disease,
• History of prolonged corticosteroid or chemotherapy treatment,