The treatment of DEH is essentially surgical removal of the osteocartilaginous lesion, usually by a pediatric orthopedic surgeon. Some authors recommend conservative treatment in early asymptomatic lesions, and surgery when the lesion is painful and is associated with joint abnormalities. Others proposed early resection, even in asymptomatic children, in order to prevent later joint complications. During surgery, any damage of the pre-existing cartilage should be avoided. The presence in the MRI of a cleavage or separation between the mass and the normal cartilage may facilitate the removal of the lesion by the surgeon. Recurrence is unlikely, but has been reported. Some children with incomplete resections may do well and do not require additional surgery.
There are recent medical publications describing resection of DEH lesions by using arthroscopic surgery. Although experience with this technique is limited, it should be considered for the treatment of intra-articular lesions.
In some cases of DEH, other types of treatment may be necessary according to the location, size of the lesion and the duration of the disease.