In the management of large cartilage defects, the two classically utilized cartilage restoration procedures are osteochondral allograft (OCA) transplantation and cell therapy, or autologous chondrocyte implantation (ACI). Trauma, osteochondritis dissecans, osteonecrosis, osteochondroses, and hereditary epiphyseal abnormalities can cause osteochondral lesions in the knee joint.25, 61, 62, 72 When an osteochondral defect persists in a weightbearing portion of the knee joint, degenerative arthritis of that compartment can result. An Osteochondral lesion is diagnosed through a physical examination, and radiographic or MRI studies. No single treatment works for everybody. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. [1] This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space. [2] That process can lead to pain, loose body formation and joint effusion.[1]  This allows us to treat the bone defect without affecting the cartilage. Regardless, each osteochondritis dissecans lesion must be followed until osseous integration is confirmed by imaging -otherwise, progression of disease to osteoarthritis is likely.” When filling osteochondral defects in the knee, surgeons have a list of treatment options to choose from and more options are in the works. In children whose bones are still growing, the bone defect may heal with a period of rest and protection. Therapy Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. Patient- and lesion-specific factors must be identified when evaluating a patient with an articular cartilage defect. Treatments. Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. Introduction. cartilage injury with associated subchondral fracture but without detachment Once the diagnosis is made, your doctor will recommend rest, ice, compression, elevation, pain medications, and assistive devices such as crutches or a wheelchair. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. An osteochondral lesion may also be known as an osteochondral defect. Within the ankle, these lesions often occur on the talus, which is the bone that joins the foot and the leg together. Treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and relieve pain, as well as reduce the risk of osteoarthritis. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … Treatment may include activity modification, drilling, fixation, or osteochondral replacement of osteochondritis dissecans lesions in the knee. Multiple treatment options are available for both traumatic osteochondral injuries and OCD lesions, with important determining factors of treatment being skeletal maturity of the patient, instability of the fragment, lesion location, and size of the lesion. 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