There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Management of Osteochondritis Dissecans (OCD) Lesion of the First Metacarpophalangeal (MCP) Joint
The management of an OCD lesion of the first MCP joint involves various treatment options, including:
- Surgical management, such as arthrotomy, excision of the loose body, and microfracture of the defect 1
- Arthroscopic treatment, including debridement and loose body removal, as well as microfracture technique 2
- Conservative methods, which may be more effective for juvenile OCD, although the evidence for this is limited in the context of the first MCP joint 3, 4
Key Considerations
When managing an OCD lesion of the first MCP joint, it is essential to consider the following factors:
- The stability of the lesion, as unstable or displaced lesions may require surgical management 3, 4
- The viability of the lesion, as well as the skeletal maturity of the patient 4
- The location of the OCD process, as this may influence the choice of treatment 4
Treatment Options
The treatment options for an OCD lesion of the first MCP joint may include:
- Reparative techniques, such as isolated removal of the fragment, bone drilling, and fixation of the osteochondral fragments 4
- Restorative techniques, such as microfractures, autologous osteochondral transplantation (mosaicplasty), autologous chondrocyte implantation, and fresh osteochondral allograft 4