High degree of consensus amongst an expert panel regarding focal resurfacing of chondral and osteochondral lesions of the femur with mini-implants

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 31; no. 9; pp. 4027 - 4034
• Main Authors: Becher, Christoph, Megaloikonomos, Panayiotis D., Lind, Martin, Eriksson, Karl, Brittberg, Mats, Beckmann, Johannes, Verdonk, Peter, Högström, Magnus, Konradsen, Lars, Holz, Johannes, Franz, Alois, Feucht, Matthias J., Kösters, Clemens, van Buul, Gerben, Sköldenberg, Olof, Emans, Pieter J., Boutefnouchet, Tarek, Nathwani, Dinesh, McNicholas, Mike J., O’Donnell, Turlough, Spalding, Tim, Stålman, Anders, Ostermeier, Sven, Imhoff, Andreas B., Shearman, Alexander D., Hirschmann, Michael
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2023; Springer Nature B.V
• Subjects: Agreements; Chondral; Consensus; Decision making; Defect; Delphi method; Femur; Guidelines; Knee; Lesions; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Mini-implants; Orthopaedic implants; Orthopedics; Ortopedi; Osteochondral; Resurfacing; Sports Medicine; Surveys; Transplants & implants; Mini-implants; Knee; Osteochondral; Chondral; Defect; Resurfacing; Consensus
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1007/s00167-023-07450-8

Introduction The rationale for the use of mini-implants for partial resurfacing in the treatment of femoral chondral and osteochondral lesions is still under debate. The evidence supporting best practise guidelines is based on studies with low-level evidence. A consensus group of experts was convened to collaboratively advance towards consensus opinions regarding the best available evidence. The purpose of this article is to report the resulting consensus statements. Methods Twenty-five experts participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted via an online survey of two rounds, for initial agreement and comments on the proposed statements. An in-person meeting between the panellists was organised during the 2022 ESSKA congress to further discuss and debate each of the statements. A final agreement was made via a final online survey a few days later. The strength of consensus was characterised as: consensus, 51–74% agreement; strong consensus, 75–99% agreement; unanimous, 100% agreement. Results Statements were developed in the fields of patient assessment and indications, surgical considerations and postoperative care. Between the 25 statements that were discussed by this working group, 18 achieved unanimous, whilst 7 strong consensus. Conclusion The consensus statements, derived from experts in the field, represent guidelines to assist clinicians in decision-making for the appropriate use of mini-implants for partial resurfacing in the treatment of femoral chondral and osteochondral lesions. Level of evidence Level V.