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

Steve Bayer, MD

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