C. Murawski (Pittsburgh, US)
Presenter Of 1 Presentation
12.1.6 - Ankle Instability in the Setting of an Osteochondral Lesion of the Talus: Results from an International Consensus Meeting
Abstract
Purpose
The purpose of this abstract is to explain the process and delineate the consensus statements derived from this consensus meeting on the treatment of concomitant ankle instability and osteochondral lesions of the ankle.
Methods and Materials
43 national and international experts in cartilage repair of the ankle were convened and participated in a process based on the Delphi method of achieving consensus. Experts were assigned to groups separated by topics, including ankle instability. Questions and statements were drafted within the groups and a comprehensive literature review was performed and, where possible, used to confirm or dispute the recommendations made. In addition, the available evidence for each statement was graded. Once the statements achieved majority vote within the working groups, a vote to the overall group was undertaken. The statements were then further edited on the basis of the discussion and votes within the entirety of the consensus group. A final vote then occurred, and the strength of consensus was characterized as follows: consensus: 51 - 74%; strong consensus: 75 - 99%; unanimous: 100%.
Results
12 statements addressing ankle instability in the presence of an osteochondral lesion reached consensus. There was a consensus that: [1] BMI, alignment, frequency/severity of sprains, history of prior ankle surgery and chronicity of symptoms should be considered prognostic factors. [2] Asymptomatic osteochondral lesions in the setting of symptomatic ankle instability do not require treatment. [3] Both a symptomatic osteochondral lesion and concomitant symptomatic ankle instability should be managed simultaneously. [4] Osteochondral lesions should be treated with the same repair/reconstruction technique with concomitant ankle instability as they would be in isolation. No statement achieved less than an 88% consensus following anonymous voting by the expert group.
Conclusion
This consensus derived from leaders in the field will assist clinicians in the treatment of ankle instability in the presence of an osteochondral lesion.