Which Berndt-Harty OCD lesion types are typically treated nonoperatively?

• A. Type I and II
• B. Type II and III
• C. Type I and III
• D. Type I and IV

Answer: (A)

Early Berndt-Harty osteochondral lesions are subchondral bone injuries that can heal without surgery when the joint surface remains largely congruent. Stage I is a small compression fracture of the subchondral bone, and stage II is a partially detached osteochondral fragment that is still in place. Because these lesions preserve joint alignment and have healing potential, nonoperative management is typically chosen, focusing on immobilization and protected weight bearing with careful follow-up to monitor healing. Once the fragment is completely detached (stage III) or displaced (stage IV), the joint surface is disrupted and healing without intervention is unlikely, so surgical treatment is usually required to restore the articular surface and prevent long-term joint degeneration.