{
  "abstract": "Knee articular cartilage lesions are frequent in football players, but evidence for the most suitable surgical treatments is lacking. The aim of this International Cartilage Regeneration & Joint Preservation Society, Fédération Internationale de Football Association and Aspetar (ICRS-FIFA-Aspetar) consensus was to develop expert-based, patient-specific practical recommendations on the appropriateness of surgical treatments for symptomatic knee articular cartilage lesions in competitive football players. The RAND/UCLA Appropriateness Method was used by 17 voting experts to provide recommendations on the suitability of six different surgical procedures (debridement, debridement+orthobiologics, bone marrow stimulation procedures, osteochondral autograft transplantation, allografts, and regenerative procedures) depending on four key clinical considerations: lesion location, defect size, bone involvement, and patient preference towards higher priority for a quick return to play or long-term results. These resulted in 96 scenarios (16 clinical scenarios for six surgical procedures). Altogether, in 94% of clinical scenarios, at least one surgical procedure was considered appropriate. Patient preference had the highest influence on the results. Debridement plus orthobiologics was most often considered appropriate in patients preferring a quick return to play, while regenerative techniques were more often considered appropriate with patients prioritising long-term results. Osteochondral autograft transplantation and allografts were considered appropriate only in selected scenarios, whereas bone marrow stimulation procedures were considered inappropriate or uncertain. The recommendations established by this ICRS-FIFA-Aspetar consensus on the appropriateness of different surgical procedures to treat symptomatic articular cartilage lesions in competitive football players should be used as broad guidelines, but the preferred treatment should be player-specific.",
  "authors": [
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Emmanuel Papakostas"
    },
    {
      "affiliations": [
        "IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy",
        "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"
      ],
      "name": "Elizaveta Kon"
    },
    {
      "affiliations": [
        "Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy"
      ],
      "name": "Luca Andriolo"
    },
    {
      "affiliations": [
        "FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland"
      ],
      "name": "Andreas Serner"
    },
    {
      "affiliations": [
        "FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland"
      ],
      "name": "Andrew Massey"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar",
        "Orthoca Orthopaedic Centre, Antwerp, Belgium"
      ],
      "name": "Peter Verdonk"
    },
    {
      "affiliations": [
        "Department of Trauma and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany",
        "Sporthopaedicum Regensburg, Regensburg, Germany"
      ],
      "name": "Peter Angele"
    },
    {
      "affiliations": [
        "Hospital Edgardo Rebagliati Martins, Lima, Peru",
        "Cirugia Especializada De Rodilla, Lima, Peru"
      ],
      "name": "Claudia Arias"
    },
    {
      "affiliations": [
        "Departamento de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, São Paulo, Brazil"
      ],
      "name": "Camila Cohen Kaleka"
    },
    {
      "affiliations": [
        "Instituto Cugat, Hospital Quironsalud Barcelona, Barcelona, Spain"
      ],
      "name": "Ramon Cugat"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Pieter D’Hooghe"
    },
    {
      "affiliations": [
        "Education and Research Department, FIFA Medical Center of Excellence, Isokinetic Medical Group, Bologna, Italy"
      ],
      "name": "Francesco Della Villa"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Cristiano Eirale"
    },
    {
      "affiliations": [
        "Alphaclinic Zurich, Zurich, Switzerland"
      ],
      "name": "Christoph Erggelet"
    },
    {
      "affiliations": [
        "Clínica Espregueira ‐ FIFA Medical Centre of Excellence, Porto, Portugal",
        "Dom Henrique Research Centre, Porto, Portugal",
        "School of Medicine, University of Minho, Braga, Portugal",
        "ICVS/3B’s‐PT Government Associate Laboratory, Braga, Portugal",
        "3B’s Research Group—Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Portugal"
      ],
      "name": "João Espregueira-Mendes"
    },
    {
      "affiliations": [
        "Gelenkpunkt - Sports and Joint Surgery, Innsbruck, Austria",
        "UMIT, Hall, Austria"
      ],
      "name": "Christian Fink"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Celeste Geertsema"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Liesel Geertsema"
    },
    {
      "affiliations": [
        "Department of Orthopedic Surgery, University of California Davis school of medicine, Sacramento, California, USA"
      ],
      "name": "Cassandra A Lee"
    },
    {
      "affiliations": [
        "Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA"
      ],
      "name": "Bert Mandelbaum"
    },
    {
      "affiliations": [
        "Osaka Health Science University, Osaka, Japan"
      ],
      "name": "Norimasa Nakamura"
    },
    {
      "affiliations": [
        "Sydney Orthopaedic Research Institute, Sydney, New South Wales, Australia"
      ],
      "name": "David A Parker"
    },
    {
      "affiliations": [
        "Orthoca Orthopaedic Centre, Antwerp, Belgium"
      ],
      "name": "Kristof Sas"
    },
    {
      "affiliations": [
        "FIFA Medical Center of Excellence, Hôpital Privé Jean Mermoz, Groupe GDS-Ramsay, Centre Orthopedique Santy, Lyon, France"
      ],
      "name": "Bertrand Sonnery-Cottet"
    },
    {
      "affiliations": [
        "Sport Science Institute of SA, Cape Town, South Africa"
      ],
      "name": "Willem van der Merwe"
    },
    {
      "affiliations": [
        "Fortius Clinic, London, UK"
      ],
      "name": "Andy Williams"
    },
    {
      "affiliations": [
        "Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy"
      ],
      "name": "Stefano Zaffagnini"
    },
    {
      "affiliations": [
        "Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"
      ],
      "name": "Bashir Ahmed Zikria"
    },
    {
      "affiliations": [
        "Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland",
        "Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland"
      ],
      "name": "Giuseppe Filardo"
    }
  ],
  "title": "ICRS-FIFA-Aspetar consensus on the management of knee cartilage injuries in football players: part 2–appropriateness of specific surgical procedures to address articular cartilage lesions in different clinical scenarios using the RAND/UCLA appropriateness method",
  "uid": "6b0c4f56-5dd3-5e77-b687-6b8332e32ea4"
}