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Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation

Journal article
Authors J. Chahla
I. R. Murray
J. Robinson
K. Lagae
F. Margheritini
B. Fritsch
M. Leyes
B. Barenius
N. Pujol
L. Engebretsen
M. Lind
M. Cohen
R. Maestu
A. Getgood
G. Ferrer
S. Villascusa
S. Uchida
B. A. Levy
R. Von Bormann
C. Brown
J. Menetrey
M. Hantes
T. Lording
Kristian Samuelsson
K. H. Frosch
J. C. Monllau
D. Parker
R. F. LaPrade
P. E. Gelber
Published in Knee Surgery Sports Traumatology Arthroscopy
Volume 27
Issue 8
Pages 2520-2529
ISSN 0942-2056
Publication year 2019
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 2520-2529
Language en
Links dx.doi.org/10.1007/s00167-018-5260-...
Keywords Posterolateral corner, Knee, Expert, Consensus, Lateral collateral ligament, Popliteus, Reconstruction, fibular collateral ligament, surgical-treatment, injuries, outcomes, reconstruction, repair, Orthopedics, Sport Sciences, Surgery
Subject categories Orthopedics

Abstract

PurposeTo develop a statement on the diagnosis, classification, treatment, and rehabilitation concepts of posterolateral corner (PLC) injuries of the knee using a modified Delphi technique.MethodsA working group of three individuals generated a list of statements relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries to form the basis of an initial survey for rating by an international group of experts. The PLC expert group (composed of 27 experts throughout the world) was surveyed on three occasions to establish consensus on the inclusion/exclusion of each item. In addition to rating agreement, experts were invited to propose further items for inclusion or to suggest modifications of existing items at each round. Pre-defined criteria were used to refine item lists after each survey. Statements reaching consensus in round three were included within the final consensus document.ResultsTwenty-seven experts (100% response rate) completed three rounds of surveys. After three rounds, 29 items achieved consensus with over 75% agreement and less than 5% disagreement. Consensus was reached in 92% of the statements relating to diagnosis of PLC injuries, 100% relating to classification, 70% relating to treatment and in 88% of items relating to rehabilitation statements, with an overall consensus of 81%.ConclusionsThis study has established a consensus statement relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries. Further research is needed to develop updated classification systems, and better understand the role of non-invasive and minimally invasive approaches along with standardized rehabilitation protocols.Level of evidenceConsensus of expert opinion, Level V.

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