Aims: Retrospective study comparing long term results after excision of osteochondral defects of the knee joint in different age groups. Methods: Fiftytwo patients with osteochondritis dissecans lesions were evaluated between 7 and 25 years after excision of a partially detached or loose fragment from the medial femoral condyles. Average follow-up was 17,2(range 7–25 years). Two groups with the same defect size and activity level during procedures were made, with 31 patients in þrst and 21 Ð in the second group. The only difference between the groups was the age; the age average in the þrst group was Ð 25,6 years (range 15 to 35 years), and Ð 45,2 years (range 35 to 55 years) in the second group. Patients were evaluated through ICRS, modiþed HSS and KOOS scales, and with x-rays. Results: Evaluation with the ICRS, modiþed HSS and KOOS rating scales for osteochondritis dissecans revealed Ð 9(17%) good results, 32(62%) Ð fair, and 11(21%) Ð failure results. Final ICRS and modiþed HSS evaluation showed statistically signiþcantly better results in the younger patients group at the 21 years (p< 0.04). At an average 17,2 year follow-up x-rays and KOOS evaluation form showed initial and second-degree (according to AhlbŠck) osteoarthritis signs in the knees. Conclusions: The long-term results of the excision of osteochondral defects of the knee joint are poor. We recommend autologous osteochondral grafting for the replacement of the osteochondritis dissecans defects in the knee joint.