Fixation for Knee Cartilage Injuries – An International Delphi Consensus Statement

Abstract

PURPOSEThe purpose of this study was to establish consensus statements via a Delphi process on cartilage fixation techniques and indications. METHODSA consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Fourteen questions were generated on cartilage fixation, with three rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80-89% agreement, whereas strong consensus was defined as 90-99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement. RESULTSOf the 14 total questions and consensus statements on cartilage fixation developed from three rounds of voting, zero achieved unanimous consensus, eight achieved strong consensus, three achieved consensus, and three did not achieve consensus. CONCLUSIONThe statements achieving strong consensus related to indications and contraindications, the expectation that younger patients experience better outcomes, an agreement that procedures should be done as soon as possible but no limit on timeframe, cartilage preparation techniques, and the use of fragment stability to guide cartilage fixation techniques. The statements that did not achieve consensus related to the minimum size of cartilage fragments that can be fixed, if purely cartilaginous lesions can be fixed, and the fixation techniques. Level of EvidenceLevel V Expert Opinion.