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

  • Jorge ChahlaEmail author
  • Iain R. Murray
  • James Robinson
  • Koen Lagae
  • Fabrizio Margheritini
  • Brett Fritsch
  • Manuel Leyes
  • Björn Barenius
  • Nicolas Pujol
  • Lars Engebretsen
  • Martin Lind
  • Moises Cohen
  • Rodrigo Maestu
  • Alan Getgood
  • Gonzalo Ferrer
  • Silvio Villascusa
  • Soshi Uchida
  • Bruce A. Levy
  • Richard Von Bormann
  • Charles Brown
  • Jacques Menetrey
  • Michael Hantes
  • Timothy Lording
  • Kristian Samuelsson
  • Karl Heinz Frosch
  • Juan Carlos Monllau
  • David Parker
  • Robert F. LaPrade
  • Pablo E. Gelber
KNEE

Abstract

Purpose

To develop a statement on the diagnosis, classification, treatment, and rehabilitation concepts of posterolateral corner (PLC) injuries of the knee using a modified Delphi technique.

Methods

A 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.

Results

Twenty-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%.

Conclusions

This 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 evidence

Consensus of expert opinion, Level V.

Keywords

Posterolateral corner Knee Expert Consensus Lateral collateral ligament Popliteus Reconstruction 

Notes

Funding

No external funding was used.

Compliance with ethical standards

Conflict of interest

P.E.G. receives board membership fees from the Spanish Arthro- scopic Association and consultancy fees from Conmed; and is an employee of Hospital Sant Pau, Barcelona, Spain. The rest of the authors have nothing to disclose.

Ethical Approval

This study does not contain any studies with human participants performed by any of the authors.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Jorge Chahla
    • 1
    Email author
  • Iain R. Murray
    • 2
  • James Robinson
    • 8
    • 9
  • Koen Lagae
    • 10
  • Fabrizio Margheritini
    • 11
  • Brett Fritsch
    • 12
  • Manuel Leyes
    • 13
  • Björn Barenius
    • 14
  • Nicolas Pujol
    • 15
    • 16
  • Lars Engebretsen
    • 17
  • Martin Lind
    • 18
  • Moises Cohen
    • 19
  • Rodrigo Maestu
    • 20
  • Alan Getgood
    • 21
  • Gonzalo Ferrer
    • 28
  • Silvio Villascusa
    • 26
  • Soshi Uchida
    • 31
  • Bruce A. Levy
    • 23
  • Richard Von Bormann
    • 24
  • Charles Brown
    • 25
  • Jacques Menetrey
    • 29
  • Michael Hantes
    • 30
  • Timothy Lording
    • 32
  • Kristian Samuelsson
    • 5
    • 33
  • Karl Heinz Frosch
    • 6
    • 7
  • Juan Carlos Monllau
    • 27
  • David Parker
    • 12
  • Robert F. LaPrade
    • 22
  • Pablo E. Gelber
    • 3
    • 4
  1. 1.Rush University Medical CenterChicagoUSA
  2. 2.Department of Orthopaedic SurgeryThe University of EdinburghEdinburghUK
  3. 3.Department of Orthopaedic Surgery, Hospital de la Sta Creu i Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain
  4. 4.ICATME-Hospital Universitari DexeusUniversitat Autònoma de BarcelonaBarcelonaSpain
  5. 5.Department of OrthopaedicsSahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg UniversityGothenburgSweden
  6. 6.University Medical Center Hamburg-EppendorfHamburgGermany
  7. 7.Asklepios Clinic St. GeorgHamburgGermany
  8. 8.Avon Orthopaedic CentreBristolUK
  9. 9.International Knee and Joint CenterAbu DhabiUAE
  10. 10.Monica HospitalsAntwerpBelgium
  11. 11.University of Rome Foro ItalicoRomeItaly
  12. 12.Sydney Orthopaedic Research InstituteSydneyAustralia
  13. 13.Clínica CEMTROMadridSpain
  14. 14.Stockholm South Hospital, Karolinska InstitutetStockholmSweden
  15. 15.Centre Hospitalier de VersaillesLe ChesnayFrance
  16. 16.Oslo University HospitalOsloNorway
  17. 17.Oslo Sports Trauma Research CenterOsloNorway
  18. 18.Aarhus University HospitalAarhusDenmark
  19. 19.Universidade Federal de São PauloSão PauloBrazil
  20. 20.Centro de tratamiento de enfermedades articularesBuenos AiresArgentina
  21. 21.Fowler Kennedy Sports Medicine ClinicLondonCanada
  22. 22.The Steadman ClinicVailUSA
  23. 23.Mayo ClinicRochesterUSA
  24. 24.Cape Town Sports & Orthopaedic ClinicCape TownSouth Africa
  25. 25.International Knee and Joint CentreAbu DhabiUAE
  26. 26.Hospital La Fraternidad HabanaMadridSpain
  27. 27.Parc de Salut Mar, UABBarcelonaSpain
  28. 28.Hospital Clinico Mutual de SeguridadSantiagoChile
  29. 29.University Hospitals of GenevaGenevaSwitzerland
  30. 30.University of ThessaliaLarissaGreece
  31. 31.Wakamatsu Hospital for the University of Occupational and Environmental HealthKitakyushuJapan
  32. 32.Melbourne Orthopaedic GroupMelbourneAustralia
  33. 33.Nanometer Structure Consortium, Lund UniversityLundSweden

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