In children younger than 12 years of age Osteochondritis dessicans will often heal spontaneously. Patients should be advised to stop sport for a period of 6-8 weeks and may be given crutches to rest the knee. The lesion should be monitored with intermittent plain X ray or MRI scan until the lesion has healed. Failure to respond may still prompt more aggressive intervention.

In older children a period of rest and non weight bearing may still be appropriate providing the articular cartilage is intact on MRI scans. If there is doubt on scans, or if the condition is not showing signs of resolution after 3-4 months conservtive management the knee should be examined arthroscopically (telescopic examination though keyhole surgery). If the lesion is loose and at risk of displacing it can be secured with small pins or screws. If the lesion looks stable it can be encouraged to heal by drilling it. Such surgery will often be done as a daycase. Patients will require a further period of 4-6 weeks restricted weight bearing until the lesion has healed.