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

Abstract

IntroductionThe 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. MethodsTwenty‐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. ResultsStatements 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. ConclusionThe 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 evidenceLevel V.

Previous cartilage surgery is associated with inferior patient‐reported outcomes after knee arthroplasty

“…Failed FCL surgery with residual symptoms remains a clinical challenge [18]. In the absence of osteoarthritis, resurfacing with mini‐implants has gained popularity and is advocated in a recent consensus paper [18]. In the present study, all previous FCL patients were reported to have osteoarthritis by the treating surgeon at the time of knee arthroplasty.…”

“…Failed FCL surgery with residual symptoms remains a clinical challenge [18]. In the absence of osteoarthritis, resurfacing with mini‐implants has gained popularity and is advocated in a recent consensus paper [18].…”