{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:55:52Z","timestamp":1791215752840,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"Abstract<\/jats:title>\n \n \n This manuscript presents the perspective of the International Society of Cartilage Repair of the Ankle (ICCRA) regarding a recent English High Court ruling that challenges established principles of evidence\u2010based sports orthopaedic care. Following a legal case involving a professional footballer and the surgical management of an ankle fracture with concomitant arthroscopy, the authors highlight significant discrepancies between the legal conclusions and the current scientific literature. The ruling suggests that arthroscopic intervention contributed to the development of ankle arthritis and premature termination of the athlete's career. However, substantial evidence demonstrates that posttraumatic ankle arthritis is a well\u2010recognised sequela of ankle fractures, particularly in the presence of prior injury and syndesmotic instability. Arthroscopy at the time of fracture fixation is widely regarded as the standard of care for identifying and managing intraarticular pathology. The judgement is critiqued for disregarding expert orthopaedic testimony, misinterpreting scientific evidence and endorsing unsupported theoretical mechanisms linking routine arthroscopic procedures to accelerated joint degeneration. The authors emphasise that such conclusions contradict accepted surgical practice and risk establishing harmful precedents that may deter appropriate management of similar injuries. This ICCRA statement highlights the need for alignment between medico\u2010legal reasoning and scientific evidence to safeguard patient care and uphold the integrity of orthopaedic decision\u2010making.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n NA.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ksa.70633","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:25:52Z","timestamp":1791213952000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When legal reasoning contradicts sports orthopaedic evidence"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7286-0689","authenticated-orcid":false,"given":"John G.","family":"Kennedy","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery NYU Langone Health New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Duke University Medical Center Durham, North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Batista","sequence":"additional","affiliation":[{"name":"Department of Arthroscopy Centro Artroscopico Jorge Batista SA Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Bayer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Clanton","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"D'Hooghe","sequence":"additional","affiliation":[{"name":"Fortius Clinic London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Dahmen","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"DiGiovanni","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Drakos","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, Foot and Ankle Service New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin R.","family":"Elliot","sequence":"additional","affiliation":[{"name":"Hampshire Hospitals NHS 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Orthopaedic Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Yonsei University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Marangon","sequence":"additional","affiliation":[{"name":"San Francesco Clinic Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"McCollum","sequence":"additional","affiliation":[{"name":"Department Orthopaedics University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Murawski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Duke University Medical Center Durham, North Carolina 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