Debridement, Curettage, and Bone Marrow Stimulation: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Author:

Hannon Charles P.1,Bayer Steve2,Murawski Christopher D.2,Canata Gian Luigi3,Clanton Thomas O.4,Haverkamp Daniel5,Lee Jin Woo6,O’Malley Martin J.7,Yinghui Hua8,Stone James W.9,Ackermann Jakob,Adams Samuel B.,Andrews Carol L.,Angthong Chayanin,Batista Jorge P.,Baur Onno L.,Becher Christoph,Berlet Gregory C.,Boakye Lorraine A. T.,Brown Alexandra J.,Buda Roberto,Calder James D.F.,Carreira Dominic S.,Dahmen Jari,D’Hooghe Pieter,DiGiovanni Christopher W.,Dombrowski Malcolm E.,Drakos Mark C.,Ferkel Richard D.,Ferrao Paulo N. F.,Fortier Lisa A.,Glazebrook Mark,Giza Eric,Gomaa Mohamed,Görtz Simon,Haleem Amgad M.,Hamid Kamran S.,Hangody Laszlo,Hertel Jay,Hintermann Beat,Hogan MaCalus V.,Hunt Kenneth J.,Hurley Eoghan T.,Karlsson Jón,Kearns Stephen R.,Kennedy John G.,Kerkhoffs Gino M. M. J.,Kim Hak Jun,Kong Siu Wah,Labib Sameh A.,Lambers Kaj T. A.,Bae Lee Keun,Ling Jeffrey S.,Longo Umile Giuseppe,Marangon Alberto,McCollum Graham,Mitchell Adam W.,Mittwede Peter N.,Nehrer Stefan,Niemeyer Philipp,Nunley James A.,Osei-Hwedieh David O.,Paul Jochen,Pearce Christopher J.,Pereira Helder,Popchak Adam,Prado Marcelo P.,Raikin Steven M.,Reilingh Mikel L.,Rothrauff Benjamin B.,Schon Lew C.,Shimozono Yoshiharu,Simpson Helene,Smyth Niall A.,Sofka Carolyn M.,Spennacchio Pietro,Sullivan Martin,Takao Masato,Tanaka Yasuhito,Thordarson David B.,Tuan Rocky,Valderrabano Victor,van Bergen Christiaan J.A.,van Dijk C. Niek,van Dijk Pim A.D.,Vannini Francesca,Vaseenon Tanawat,Walther Markus,Wiewiorski Martin,Xu Xiangyang,Yasui Youichi,Yoshimura Ichiro,Younger Alastair S. E.,Zhang Zijun

Affiliation:

1. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

2. Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

3. Centre of Sports Traumatology, Koelliker Hospital, Turin, Italy

4. The Steadman Clinic, Vail, CO, USA

5. Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands

6. Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

7. Foot and Ankle Service, Hospital for Special Surgery, New York, NY, USA

8. Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China

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.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

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