Terminology for osteochondral lesions of the ankle: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Christopher D Murawski¹, M Shazil Jamal², Eoghan T Hurley³, Roberto Buda⁴, Kenneth Hunt⁵, Graham McCollum⁶, Jochen Paul⁷, Francesca Vannini⁸, Markus Walther⁹, Youichi Yasui¹⁰, Zakariya Ali¹¹, J Nienke Altink¹², Jorge Batista¹³, Steve Bayer¹⁴, Gregory C Berlet¹⁵, James D F Calder¹⁶, Jari Dahmen¹², Martin S Davey¹¹, Pieter D'Hooghe¹⁷, Christopher W DiGiovanni¹⁸, Richard D Ferkel¹⁹, Arianna L Gianakos¹⁸, Eric Giza²⁰, Mark Glazebrook²¹, Laszlo Hangody²², Daniel Haverkamp²³, Beat Hintermann²⁴, Yinghui Hua²⁵, Daire J Hurley²⁶, Jón Karlsson²⁷, Stephen Kearns²⁸, John G Kennedy²⁹, Gino M M J Kerkhoffs¹², Kaj Lambers¹², Jin Woo Lee³⁰, Nathaniel P Mercer²⁹, Conor Mulvin¹¹, James A Nunley³¹, Christopher Pearce³², Helder Pereira³³, Marcelo Prado³⁴, Steven M Raikin³⁵, Ian Savage-Elliott³⁶, Lew C Schon³⁷, Yoshiharu Shimozono³⁸, James W Stone³⁹, Sjoerd A S Stufkens¹², Martin Sullivan⁴⁰, Masato Takao⁴¹, Hajo Thermann⁴², David Thordarson⁴³, James Toale¹¹, Victor Valderrabano⁴⁴, Christiaan J A van Bergen⁴⁵, C Niek van Dijk¹², Raymond J Walls²⁹, Alastair S Younger⁴⁶, MaCalus V Hogan¹⁴

Affiliations

¹ University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Pittsburgh, PA, USA. Electronic address: cdmurawski@gmail.com.
² Royal London Hospital, London, United Kingdom.
³ Sports Surgery Clinic, Dublin, Ireland.
⁴ Clinic of Orthopaedics and Traumatology, SS. Annunziata Hospital, University of Chieti-Pescara, Italy.
⁵ Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
⁶ Department Orthopaedics, University of Cape Town, Cape Town, South Africa.
⁷ Rennbahnklinik, Muttenz, Basel, Switzerland.
⁸ Istituti Ortopedici Rizzoli, Bologna University, Bologna, Italy.
⁹ Schoen Klinik Muenchen Harlaching, Academic Hospital of Ludwig-Maximilians-University Munich, Munich, Germany.
¹⁰ Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
¹¹ Royal College of Surgeons Ireland, Dublin, Ireland.
¹² Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, Netherlands.
¹³ Department of Arthroscopy, Centro Artroscopico Jorge Batista SA, Buenos Aires, Argentina.
¹⁴ University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
¹⁵ Orthopedic Foot and Ankle Center, Worthington, OH, USA.
¹⁶ Fortius Clinic, London, United Kingdom.
¹⁷ Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
¹⁸ Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
¹⁹ Southern California Orthopedic Institute, Los Angeles, CA, USA.
²⁰ Department of Orthopaedics, University of California, Davis, Sacramento, CA, USA.
²¹ Dalhousie University & Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
²² Semmelweis University, Department of Traumatology, Uzsoki Hospital, Department of Orthopedics, Budapest, Hungary.
²³ Xpert Clinics Orthopedics, Amsterdam, the Netherlands.
²⁴ Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland.
²⁵ Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
²⁶ Mater Misericordiae University Hospital, Dublin, Ireland.
²⁷ Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden.
²⁸ National University of Ireland Galway, Galway, Ireland.
²⁹ NYU Langone Health, New York, NY, USA.
³⁰ Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea.
³¹ Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
³² National University Heath System, Division of Foot and Ankle Surgery, Singapore.
³³ Knee and Ankle Unit of Orthopedic Department of Póvoa de Varzim - Vila Do Conde, Porto, Portugal.
³⁴ Orthopedics Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.
³⁵ Rothman Institute, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
³⁶ Department of Orthopedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
³⁷ Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA; NYU Langone Health, New York, NY, USA.
³⁸ Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
³⁹ The Orthopedic Institute of Wisconsin, Franklin, WI, USA.
⁴⁰ St Vincent's Clinic, Sydney, Australia.
⁴¹ Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Chiba, Japan.
⁴² ATOS Clinic, Heidelberg, Germany.
⁴³ Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
⁴⁴ Swiss Ortho Center, Basel, Switzerland.
⁴⁵ Department of Orthopaedic Surgery, Amphia, Breda, Netherlands.
⁴⁶ Department of Orthopedics, University of British Columbia, Vancouver, BC, Canada.

PMID: 35546437
DOI: 10.1016/j.jisako.2021.12.001

Free article

Review

Terminology for osteochondral lesions of the ankle: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Christopher D Murawski et al. J ISAKOS. 2022 Apr.

Free article

. 2022 Apr;7(2):62-66.

doi: 10.1016/j.jisako.2021.12.001. Epub 2022 Jan 14.

Authors

Affiliations

¹ University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Pittsburgh, PA, USA. Electronic address: cdmurawski@gmail.com.
² Royal London Hospital, London, United Kingdom.
³ Sports Surgery Clinic, Dublin, Ireland.
⁴ Clinic of Orthopaedics and Traumatology, SS. Annunziata Hospital, University of Chieti-Pescara, Italy.
⁵ Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
⁶ Department Orthopaedics, University of Cape Town, Cape Town, South Africa.
⁷ Rennbahnklinik, Muttenz, Basel, Switzerland.
⁸ Istituti Ortopedici Rizzoli, Bologna University, Bologna, Italy.
⁹ Schoen Klinik Muenchen Harlaching, Academic Hospital of Ludwig-Maximilians-University Munich, Munich, Germany.
¹⁰ Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
¹¹ Royal College of Surgeons Ireland, Dublin, Ireland.
¹² Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, Netherlands.
¹³ Department of Arthroscopy, Centro Artroscopico Jorge Batista SA, Buenos Aires, Argentina.
¹⁴ University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
¹⁵ Orthopedic Foot and Ankle Center, Worthington, OH, USA.
¹⁶ Fortius Clinic, London, United Kingdom.
¹⁷ Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
¹⁸ Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
¹⁹ Southern California Orthopedic Institute, Los Angeles, CA, USA.
²⁰ Department of Orthopaedics, University of California, Davis, Sacramento, CA, USA.
²¹ Dalhousie University & Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
²² Semmelweis University, Department of Traumatology, Uzsoki Hospital, Department of Orthopedics, Budapest, Hungary.
²³ Xpert Clinics Orthopedics, Amsterdam, the Netherlands.
²⁴ Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland.
²⁵ Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
²⁶ Mater Misericordiae University Hospital, Dublin, Ireland.
²⁷ Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden.
²⁸ National University of Ireland Galway, Galway, Ireland.
²⁹ NYU Langone Health, New York, NY, USA.
³⁰ Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea.
³¹ Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
³² National University Heath System, Division of Foot and Ankle Surgery, Singapore.
³³ Knee and Ankle Unit of Orthopedic Department of Póvoa de Varzim - Vila Do Conde, Porto, Portugal.
³⁴ Orthopedics Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.
³⁵ Rothman Institute, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
³⁶ Department of Orthopedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
³⁷ Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA; NYU Langone Health, New York, NY, USA.
³⁸ Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
³⁹ The Orthopedic Institute of Wisconsin, Franklin, WI, USA.
⁴⁰ St Vincent's Clinic, Sydney, Australia.
⁴¹ Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Chiba, Japan.
⁴² ATOS Clinic, Heidelberg, Germany.
⁴³ Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
⁴⁴ Swiss Ortho Center, Basel, Switzerland.
⁴⁵ Department of Orthopaedic Surgery, Amphia, Breda, Netherlands.
⁴⁶ Department of Orthopedics, University of British Columbia, Vancouver, BC, Canada.

PMID: 35546437
DOI: 10.1016/j.jisako.2021.12.001

Abstract

Background: 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 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 "terminology for osteochondral lesions of the ankle" developed at the 2019 International Consensus Meeting on Cartilage Repair of the Ankle.

Methods: Forty-three international experts in cartilage repair of the ankle representing 20 countries were convened 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 characterised as follows: consensus, 51%-74%; strong consensus, 75%-99%; unanimous, 100%.

Results: 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.

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

Keywords: Ankle; Cartilage; Osteochondral lesion; Talus.

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Terminology for osteochondral lesions of the ankle: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Affiliations

Terminology for osteochondral lesions of the ankle: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Authors

Affiliations

Abstract

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LinkOut - more resources

Full Text Sources

Medical