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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 David Silver Professor and Chair of UPMC Orthopaedic Surgery, MaCalus V. Hogan, MD, MBA, 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
UPMC Orthopaedic Care hosted the International Consensus Meeting on Cartilage Repair of the Ankle in Pittsburgh in 2017. Learn more here.