Pittsburgh 2017
The following video clips are some highlights from the 2017 International Consensus on Cartilage Repair of the Ankle as published in FOOT & ANKLE INTERNATIONAL.
Introduction
These consensus statements were developed to guide surgeons from all over the world when treating these difficult clinical injuries.
Methodology
All experts provided their expertise in a structure manner and an intense, year-long process allowed the consensus statements to be developed.
The results were published in the first ever supplemental issue of Foot and Ankle International.
Imaging Diagnosis
Which radiographic/imaging studies can be utilized to evaluate a known or suspected cartilage lesion of the ankle?
Documenting Lesion Location
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How can the location of a lesion(s) be documented? |
| FOOT & ANKLE INTERNATIONAL Volume 9 |
Lesion Size Measurement
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How can lesion size be measured on imaging? FOOT & ANKLE INTERNATIONAL Volume 9 |
Conservative Management Protocol
What is the optimal protocol for conservative management (eg, brace, cast, boot, PT, etc) of a cartilage lesion of the ankle?
Duration of Conservative Management
For how long can conservative management be attempted before surgery is recommended?
Biological Augmentation
Is there an optimal formulation, cell source, or cell concentration of the available biological products in the setting of cartilage repair?
Ideal Lesion Size Guidelines
What are the ideal lesion size guidelines (diameter, depth, etc) for the use of bone marrow stimulation in the primary surgical treatment of an osteochondral lesion of the talus?
Treatment Failure
How can treatment failure be defined and what are the diagnostic criteria in the setting of cartilage repair of the ankle?
Can Previous Treatment Affect a Subsequent Procedure?
Does a previous debridement, curettage, and/or bone marrow stimulation procedure affect the outcome of a subsequent procedure?
Retrograde Drilling
What size drill can be utilized for retrograde drilling of a subchondral lesion of the ankle?
Cysts
Are postoperative cysts a concern after osteochondral autograft procedures? If so, can they be avoided or treated?
Fixation
In what cases/lesion types can fixation be considered for the surgical treatment of a cartilage lesion of the ankle?
Allograft
How can patients be counseled with regards to goals for postoperative function after bulk osteochondral allograft procedures?
Bone Loss
What amount of bone loss necessitates grafting of a defect prior to utilizing a scaffold?
Biological Augmentation for Bone Marrow Stimulation
Can biological augmentation of a bone marrow stimulation procedure be considered?
Scaffolds
In what cases can the addition of a scaffold to bone marrow stimulation (eg, matrix-augmented bone marrow stimulation) be considered?
Post-Treatment Imaging
Should radiographic/imaging studies be obtained on patients after treatment of a cartilage lesion of the ankle? If so, which studies and which specific imaging protocol(s)?
Weight-bearing Protocols
Is there a benefit(s) to early versus delayed weight bearing after cartilage repair of the ankle?
Post-Treatment Imaging Findings
For how long after cartilage repair of the ankle can clinicians and radiologists agree that there will be expected visualization of postoperative subchondral edema on imaging?
Clinical Function or Imaging?
Does clinical function correlate with the appearance of post-treatment imaging?