Abstract
Background
The optimal approach to fixation techniques in cartilage repair of the ankle remains unclear due to the predominance of low-quality evidence and limited high-level studies. To address this gap, an international group of experts convened to establish consensus-based recommendations grounded in the best available evidence, formulated during the 2017 International Congress on Cartilage Repair of the Ankle.
Methods
Seventy-five multidisciplinary experts from 25 countries and 1 territory participated in a structured Delphi-based consensus process. Eleven working groups were tasked with reviewing specific topics within cartilage repair of the ankle, conducting systematic literature reviews, and grading evidence to support each statement. Statements lacking full agreement were further discussed and refined before final voting. Consensus strength was defined as consensus (51%-74%), strong consensus (75%-99%), or unanimous (100%).
Results
Fifteen consensus statements related to fixation techniques were developed and all achieved strong consensus, with a minimum agreement level of 82%. These statements provide standardized guidance on indications, technical considerations, and expected outcomes for fixation procedures in osteochondral lesions of the talus.
Conclusion
This synthesis of the international expert consensus statements offers unified recommendations to guide the use of fixation techniques in the management of osteochondral lesions of the talus, fostering greater consistency in clinical practice, research methodology, and future guideline development.