Charles P Hannon1, Steve Bayer2, Christopher D Murawski2, Gian Luigi Canata3, Thomas O Clanton4, Daniel Haverkamp5, Jin Woo Lee6, Martin J O'Malley7, Hua Yinghui8, James W Stone9. 1. 1 Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. 2. 2 Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 3. 3 Centre of Sports Traumatology, Koelliker Hospital, Turin, Italy. 4. 4 The Steadman Clinic, Vail, CO, USA. 5. 5 Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands. 6. 6 Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 7. 7 Foot and Ankle Service, Hospital for Special Surgery, New York, NY, USA. 8. 8 Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China. 9. 9 The Orthopedic Institute of Wisconsin, Franklin, WI, USA.
Abstract
BACKGROUND: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on "Debridement, Curettage and Bone Marrow Stimulation" developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. METHODS: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 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 upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. RESULTS: A total of 14 statements on debridement, curettage, and bone marrow stimulation reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support, 12 reached strong consensus (greater than 75% agreement), and 1 achieved consensus. All statements reached at least 72% agreement. CONCLUSIONS: This international consensus derived from leaders in the field will assist clinicians with debridement, curettage and bone marrow stimulation as a treatment strategy for osteochondral lesions of the talus.
BACKGROUND: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on "Debridement, Curettage and Bone Marrow Stimulation" developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. METHODS: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 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 upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. RESULTS: A total of 14 statements on debridement, curettage, and bone marrow stimulation reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support, 12 reached strong consensus (greater than 75% agreement), and 1 achieved consensus. All statements reached at least 72% agreement. CONCLUSIONS: This international consensus derived from leaders in the field will assist clinicians with debridement, curettage and bone marrow stimulation as a treatment strategy for osteochondral lesions of the talus.
Entities:
Keywords:
ankle; bone marrow stimulation; debridement; microfracture; osteochondral lesion; talus
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