What lesion is a ≤1 cm² stable osteochondral defect in the central‑lateral femoral trochlear groove with attached fragment?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 25, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Osteochondral Lesion of the Femoral Trochlear Groove

This is an osteochondral defect (OCD lesion) of the central-lateral femoral trochlear groove with an attached fragment, representing a stable osteochondritis dissecans lesion. 1, 2

Lesion Classification and Characteristics

  • Osteochondritis dissecans (OCD) is the correct diagnosis when an osteochondral fragment remains attached to the underlying subchondral bone in the trochlear groove. 3, 2

  • The central-lateral trochlear groove location is rare, accounting for only approximately 50 documented cases in the literature prior to modern imaging, making this an uncommon presentation of OCD. 2

  • A ≤1 cm² lesion with an attached fragment is classified as a stable lesion because the cartilage and underlying bone remain connected to the parent bone, distinguishing it from unstable or loose body formations. 1, 3

  • The stability of the fragment is the critical determinant of prognosis and treatment approach—stable lesions have significantly better outcomes than unstable or detached fragments. 3, 4

Diagnostic Considerations

  • MRI is essential for complete evaluation because almost half of trochlear groove OCD lesions may not be visible on plain radiographs, and MRI determines fragment stability and viability. 2

  • One quarter of trochlear OCD lesions are associated with concurrent OCD lesions elsewhere in the same knee, requiring comprehensive joint evaluation. 2

  • The Bedouelle classification system should be used to stage the lesion based on all available imaging (radiographs, MRI, and arthroscopy findings) to guide treatment decisions. 4

Clinical Pitfalls

  • Do not confuse this with a bone bruise or simple chondral delamination—an osteochondral lesion involves both cartilage and underlying subchondral bone, whereas bone bruising represents marrow edema without structural cartilage defect. 5

  • Trochlear location behaves differently from condylar OCD lesions in terms of biomechanics and repair potential, so treatment algorithms developed for condylar lesions cannot be directly extrapolated. 2, 6

  • The presence of an attached fragment indicates this is not a loose body requiring removal, but rather a potentially salvageable lesion that may heal with appropriate intervention. 3, 4

References

1
Guideline

Guideline for Treatment of Small Central‑Lateral Trochlear Groove Osteochondral Lesions

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

4
Research

[Osteochondritis dissecans of the femoral condyles: report of 892 cases].

Revue de chirurgie orthopedique et reparatrice de l'appareil moteur, 2006

5
Guideline

Bone Marrow Aspiration with Injection for Patellar Subchondral Bone Bruising

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

6
Research

Improved repair of chondral and osteochondral defects in the ovine trochlea compared with the medial condyle.

Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2013

Related Questions

What does a spiculated hyperdensity at the caudal aspect of the femur indicate?
What is an alternative to Dulera (fluticasone propionate/salmeterol)?
In a young, active patient with a stable central‑lateral trochlear groove osteochondral lesion ≤1 cm² and minimal symptoms, how should it be managed?
Can bilirubin be normal in chronic liver disease?
What baseline and follow‑up laboratory tests should be ordered for a patient with suspected or known chronic liver disease?
What is the appropriate evaluation and management of a patient with a suspected concussion, including red‑flag assessment, indications for non‑contrast head CT, return‑to‑play/return‑to‑learn protocol, and analgesic recommendations?
Can increased dietary nickel intake cause problems in a patient taking buspirone (Buspar)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question