ICRS-FIFA-Aspetar consensus on the management of knee cartilage injuries in football players: part 1 – appropriateness of surgery in different clinical scenarios using the RAND/UCLA appropriateness method

Knee cartilage lesions are frequent in football players, but evidence for surgical treatment 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 specific expert-based, patient-specific practical recommendations on the appropriateness of non-surgical or surgical treatments for symptomatic knee cartilage lesions in competitive football players. The RAND/UCLA appropriateness method was used, and 17 voting experts provided recommendations on the appropriateness of surgical treatment in 96 different clinical scenarios defined on 6 variables: cartilage injury onset, lesion location, defect size, bone involvement, player symptom level and preference towards higher priority of a quick return to play or long-term results. Surgical treatment of a cartilage lesion was considered appropriate in 32% of the scenarios, in 21% inappropriate, while in 47% of the scenarios, the appropriateness was considered uncertain. The parameters with the highest appropriateness for the surgical treatment of a cartilage lesion in a football player were the inability to play (75.0% of appropriate scenarios), a lesion sized 2 cm<sup>2</sup> or bigger (47.9% of appropriate scenarios) and the preference of the player for long-term results (41.7% of appropriate scenarios). In this ICRS-FIFA-Aspetar expert consensus, surgical treatment for cartilage injuries in competitive football players was considered appropriate only in one-third of the clinical scenarios, and the choice was mainly driven by the level of symptoms. Surgical preference was also influenced by larger lesions, lesions of the condyles and trochlea with subchondral bone involvement and player's preference towards long-term results.

Authors

Institutions

Publication Details

Journal
British Journal of Sports Medicine
Published
2025-02-12
DOI
https://doi.org/10.1136/bjsports-2024-108960
Citations
1
Primary Topic
Knee injuries and reconstruction techniques
Type
article
Field-Weighted Citation Impact
2.01

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

ICRS-FIFA-Aspetar consensus on the management of knee cartilage injuries in football players: part 1 – appropriateness of surgery in different clinical scenarios using the RAND/UCLA appropriateness method

Celeste Geertsema, Kristof Sas, Norimasa Nakamura, Elizaveta Kon et al.
1 citations
British Journal of Sports Medicine
Knee injuries and reconstruction techniques
2.01
article

ICRS-FIFA-Aspetar consensus on the management of knee cartilage injuries in football players: part 1 – appropriateness of surgery in different clinical scenarios using the RAND/UCLA appropriateness method

Celeste Geertsema, Kristof Sas, Norimasa Nakamura, Elizaveta Kon, Bert R. Mandelbaum, Stefano Zaffagnini, Bashir Zikria, Peter Angele, Claudia Arias, Cassandra A. Lee, Andreas Serner, Camila Cohen Kaleka, Pieter P. R. N. d’Hooghe, Ramón Cugat, Peter Verdonk, Francesco Della Villa, Christoph Erggelet, Andrew Massey, Luca Andriolo, Christian Fink, Andy M. Williams, Liesel Geertsema, Cristiano Eirale, David Parker, Giuseppe Filardo, Emmanouil Papakostas, Bertrand Sonnery‐Cottet, João Espregueira-Mendes, Willem van der Merwe
article en
1 citations

Abstract

Knee cartilage lesions are frequent in football players, but evidence for surgical treatment 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 specific expert-based, patient-specific practical recommendations on the appropriateness of non-surgical or surgical treatments for symptomatic knee cartilage lesions in competitive football players. The RAND/UCLA appropriateness method was used, and 17 voting experts provided recommendations on the appropriateness of surgical treatment in 96 different clinical scenarios defined on 6 variables: cartilage injury onset, lesion location, defect size, bone involvement, player symptom level and preference towards higher priority of a quick return to play or long-term results. Surgical treatment of a cartilage lesion was considered appropriate in 32% of the scenarios, in 21% inappropriate, while in 47% of the scenarios, the appropriateness was considered uncertain. The parameters with the highest appropriateness for the surgical treatment of a cartilage lesion in a football player were the inability to play (75.0% of appropriate scenarios), a lesion sized 2 cm<sup>2</sup> or bigger (47.9% of appropriate scenarios) and the preference of the player for long-term results (41.7% of appropriate scenarios). In this ICRS-FIFA-Aspetar expert consensus, surgical treatment for cartilage injuries in competitive football players was considered appropriate only in one-third of the clinical scenarios, and the choice was mainly driven by the level of symptoms. Surgical preference was also influenced by larger lesions, lesions of the condyles and trochlea with subchondral bone involvement and player's preference towards long-term results.

British Journal of Sports MedicineVol. 59(13)
OTH Regensburg (DE), Humanitas University (IT), Hospital Israelita Albert Einstein (BR), Fédération Internationale de Football Association (CH), University Hospital Regensburg (DE), Cedars-Sinai Kerlan-Jobe Institute (US), Hospital Nacional Cayetano Heredia (PE), Qatar Orthopaedic and Sports Medicine Hospital (QA), Antwerp University Hospital (BE), Osaka Health Science University (JP), UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik (AT), Hospital Quirónsalud Barcelona (ES), The Geneva Association (CH), Province of Antwerp (BE), Istituto Ortopedico Rizzoli (IT), Centre Orthopédique Santy (FR), FC Barcelona (ES), Sports Science Institute of South Africa (ZA), Fortius Clinic (GB), Gelenkpunkt (AT), IRCCS Humanitas Research Hospital (IT), Sydney Orthopaedic Research Institute (AU), Università della Svizzera italiana (CH), University of California, Davis (US), University of Minho (PT)
Aspetar Orthopaedic and Sports Medicine Hospital
Good health and well-being
Openalex Percentile: Top 19%
Knee injuries and reconstruction techniques
2.01
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.