The following video clips are 22 highlights from the 2017 International Consensus on Cartilage Repair of the Ankle as published in FOOT & ANKLE INTERNATIONAL.

Clip downloads can be ordered from the ON Foundation office

With Challenge Comes Opportunity

There was a unique opportunity available to make an impact on the diagnosis, treatment and rehabilitation of these injuries. A modified version of the Delphi method was utilized to develop the consensus statements, and these videos will help to communicate the consensus statements among orthopedic surgeons and researchers throughout the world.

Introduction

To find consensus takes time, but the 2017 meeting in Pittsburgh brought a break-through.

Introduction

The process started in 2011 with the goal to gather a group of surgeons from all over the world to agree on the best way to diagnose, treat and rehabilitate osteochondral lesions of the ankle.

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.

FOOT & ANKLE INTERNATIONAL Volume 9 

Imaging Diagnosis

Which radiographic/imaging studies can be utilized to evaluate a known or suspected cartilage lesion of the ankle?

FOOT & ANKLE INTERNATIONAL Volume 9 

Documenting Lesion Location

How can the location of a lesion(s) be documented?

FOOT & ANKLE INTERNATIONAL Volume 9 

Lesion Size Measurement

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?

FOOT & ANKLE INTERNATIONAL Volume 9 

Duration of Conservative Management

For how long can conservative management be attempted before surgery is recommended?

FOOT & ANKLE INTERNATIONAL Volume 9 

Biological Augmentation

Is there an optimal formulation, cell source, or cell concentration of the available biological products in the setting of cartilage repair?

FOOT & ANKLE INTERNATIONAL Volume 9 

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? 

FOOT & ANKLE INTERNATIONAL Volume 9 

Treatment Failure

How can treatment failure be defined and what are the diagnostic criteria in the setting of cartilage repair of the ankle?

FOOT & ANKLE INTERNATIONAL Volume 9 

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?

FOOT & ANKLE INTERNATIONAL Volume 9 

Retrograde Drilling

What size drill can be utilized for retrograde drilling of a subchondral lesion of the ankle?

FOOT & ANKLE INTERNATIONAL Volume 9 

Cysts

Are postoperative cysts a concern after osteochondral autograft procedures? If so, can they be avoided or treated?

FOOT & ANKLE INTERNATIONAL Volume 9 

Fixation

In what cases/lesion types can fixation be considered for the surgical treatment of a cartilage lesion of the ankle?

FOOT & ANKLE INTERNATIONAL Volume 9 

Allograft

How can patients be counseled with regards to goals for postoperative function after bulk osteochondral allograft procedures?

FOOT & ANKLE INTERNATIONAL Volume 9 

Bone Loss

What amount of bone loss necessitates grafting of a defect prior to utilizing a scaffold?

FOOT & ANKLE INTERNATIONAL Volume 9 

Biological Augmentation for Bone Marrow Stimulation

Can biological augmentation of a bone marrow stimulation procedure be considered?

FOOT & ANKLE INTERNATIONAL Volume 9 

Scaffolds

In what cases can the addition of a scaffold to bone marrow stimulation (eg, matrix-augmented bone marrow stimulation) be considered?

FOOT & ANKLE INTERNATIONAL Volume 9 

Treatment Success

How can treatment success be defined?

FOOT & ANKLE INTERNATIONAL Volume 9 

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)? 

FOOT & ANKLE INTERNATIONAL Volume 9 

Weight-bearing Protocols

Is there a benefit(s) to early versus delayed weight bearing after cartilage repair of the ankle?

FOOT & ANKLE INTERNATIONAL Volume 9 

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? 

FOOT & ANKLE INTERNATIONAL Volume 9 

Clinical Function or Imaging?

Does clinical function correlate with the appearance of post-treatment imaging?

FOOT & ANKLE INTERNATIONAL Volume 9