Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

November 1, 2022

Proceedings on two topics from the International Consensus Meetings on Cartilage Repair of the Ankle, focusing on pediatric ankle cartilage lesions and terminology for osteochondral lesions of the ankle, were recently published in the Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine.

The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts, including UPMC Orthopaedic Care physician MaCalus V. Hogan, MD, was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle.

Forty-three international experts in cartilage repair of the ankle representing 20 countries were convened at the Royal College of Surgeons–Ireland in Dublin and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within four working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed, and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed on in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51%-74%; strong consensus, 75%-99%; unanimous, 100%.

This international consensus derived from leaders in the field will assist clinicians with the appropriate terminology for osteochondral lesions of the ankle.

A total of 11 statements on terminology and classification reached consensus during the 2019 International Consensus Meeting on Cartilage Repair of the Ankle. Definitions are provided for osseous, chondral and osteochondral lesions, as well as bone marrow stimulation and injury chronicity, among others. An osteochondral lesion of the talus can be abbreviated as OLT.

Experts in the international consensus group included:

Christopher Murawski, MD
UPMC


Steve Bayer, MD
UPMC


M. Shazil Jamal, MD
Royal London Hospital


Eoghan T. Hurley, MD
Sports Surgery Clinic, Dublin, Ireland


Roberto Buda
Clinic of Orthopaedics and Traumatology, SS. Annunziata Hospital, University of Chieti-Pescara, Italy


Kenneth Hunt, MD
University of Colorado School of Medicine


Graham McCollum, MD
University of Cape Town


Jochen Paul, MD 
Rennbahnklinik, Muttenz, Basel, Switzerland


Francesca Vannini, MD
Istituto Ortopedico Rizzoli


Markus Walther, MD
Schön Klinik München Harlaching


Youichi Yasui, MD
Teikyo University


Zakariya Ali, MD
Royal College of Surgeons Ireland


J. Nienke Altink, MD
Amsterdam UMC


Jorge Batista, ISR, DEEC/FCT
Centro Artroscopico Jorge Batista SA


Gregory C. Berlet, MD
Orthopedic Foot and Ankle Center


James D. F. Calder, MD
Fortius Clinic


Jari Dahmen
Amsterdam UMC


Martin S. Davey
Royal College of Surgeons Ireland


Pieter D’Hooghe, MD
Aspetar Orthopaedic and Sports Medicine Hospital


Christopher DiGiovanni, MD
Massachusetts General Hospital


Richard D. Ferkel, MD
Southern California Orthopedic Institute


Arianna L. Gianakos, DO
Massachusetts General Hospital


Eric Giza, MD
UC Davis Health


Mark Glazebrook, MD
Dalhousie University


Laszlo Hangody, MD
Semmelweis University, Uzsoki Hospital, Budapest, Hungary


Daniel Haverkamp, MD
Xpert Clinics Orthopedics, Amsterdam, the Netherlands


Beat Hintermann, MD
Kantonsspital Baselland, Liestal, Switzerland


Yinghui Hua, MD
Huashan Hospital, Fudan University, Shanghai, China


Daire J. Hurley, MD
Mater Misericordiae University Hospital


Jon Karlsson, MD
Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University


Stephen Kearns, MD
National University of Ireland


John G. Kennedy, MD
NYU Langone Health


Gino M. M. J. Kerkhoffs, MD
Amsterdam UMC


Kaj Lambers, MD
Amsterdam UMC


Jin Woo Lee, MD
Yonsei University


Nathaniel P. Mercer, MD
NYU Langone Health


Conor Mulvin, MD
Royal College of Surgeons


James A. Nunley, MD
Duke University


Christopher Pearce, MD
National University Health System


Helder Pereira, PhD
Knee and Ankle Unit of Orthopedic Department of Póvoa de Varzim - Vila Do Conde, Porto, Portugal


Marcelo Prado, MD
Hospital Israelita Albert Einstein


Steven M. Raikin, MD
Rothman Orthopedic Institute


Ian Savage Elliott, MD
Tulane University School of Medicine


Lew C. Schon, MD
Mercy Medical Center


Yoshiharu Shimozono, MD
Kyoto University Graduate School of Medicine


James W. Stone, MD
Orthopedic Institute of Wisconsin


Sjoerd A. S. Stufkens, PhD
Amsterdam UMC


Martin Sullivan, MD
St. Vincent’s Clinic


Masato Takao, MD, PhD
Clinical and Research Institute for Foot & Ankle Surgery, Jujo Hospital


Hajo Thermann, MD
ATOS Clinic, Heidelberg, Germany


David Thordarson, MD
Cedars Sinai Medical Center


James Toale, MD
Royal College of Surgeons Ireland


Victor Valderrabano, MD
Swiss Ortho Center, Basel, Switzerland


Christiaan J. A. van Bergen, MD
Erasmus University Medical Center


Stephane Guillo, MD
Sports Clinic Bordeaux Mérignac


C. Niek van Diek, MD
Amphia, Breda, Netherlands


Raymond J. Walls, MD
NYU Langone Health 


Alastair S. Younger, MD
University of British Columbia