Research in OsteoChondritis of the Knee-ROCK Research Study Group.

Knee osteochondritis dissecans (OCD) is a condition affecting the articular cartilage and subchondral bone, predominantly in young athletes, which has historically suffered from a lack of high-quality evidence to guide diagnosis and treatment. In response to the 2010 American Academy of Orthopaedic Surgeons (AAOS) clinical practice guideline, which identified critical gaps in OCD research, the Research in OsteoChondritis of the Knee (ROCK) group was established as an international, multicenter research consortium with the goal of advancing the clinical understanding and treatment of knee OCD. Since 2010, ROCK has enrolled more than 1,900 patients across 25 centers involving more than 40 orthopaedic surgeons, representing one of the largest prospective cohorts of patients with knee OCD in the literature. The group's work has spanned epidemiologic characterization, patient-reported outcome collection, imaging classification, predictive modeling, and randomized controlled trials. Epidemiologic findings revealed that OCD most commonly affects adolescent boys, with the medial femoral condyle representing the most frequent lesion site. ROCK developed and validated reliable classification systems for radiographs, MRI, and arthroscopy, achieving excellent interobserver and intraobserver reliability across all modalities. Patient-reported outcome measures, including the KOOS QoL, Pedi-IKDC, and Pedi-FABS, were systematically collected to better define the functional impact of OCD. Predictive modeling efforts identified key lesion and demographic factors associated with healing failure, while a landmark randomized controlled trial established comparable functional outcomes between transarticular and retroarticular drilling techniques. These collective contributions demonstrate the critical impact of organized multicenter research in advancing evidence-based care for patients with knee OCD.