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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Funding

No external funding was used.

Author information

Authors and Affiliations

  1. Rush University Medical Center, 1611 W Harrison, Suite 300, Chicago, IL, 60612, USA

    Jorge Chahla

  2. Department of Orthopaedic Surgery, The University of Edinburgh, Edinburgh, UK

    Iain R. Murray

  3. Department of Orthopaedic Surgery, Hospital de la Sta Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    Pablo E. Gelber

  4. ICATME-Hospital Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain

    Pablo E. Gelber

  5. Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Kristian Samuelsson

  6. University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Karl Heinz Frosch

  7. Asklepios Clinic St. Georg, Hamburg, Germany

    Karl Heinz Frosch

  8. Avon Orthopaedic Centre, Bristol, UK

    James Robinson

  9. International Knee and Joint Center, Abu Dhabi, UAE

    James Robinson

  10. Monica Hospitals, Antwerp, Belgium

    Koen Lagae

  11. University of Rome Foro Italico, Rome, Italy

    Fabrizio Margheritini

  12. Sydney Orthopaedic Research Institute, Sydney, Australia

    Brett Fritsch & David Parker

  13. Clínica CEMTRO, Madrid, Spain

    Manuel Leyes

  14. Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden

    Björn Barenius

  15. Centre Hospitalier de Versailles, Le Chesnay, France

    Nicolas Pujol

  16. Oslo University Hospital, Oslo, Norway

    Nicolas Pujol

  17. Oslo Sports Trauma Research Center, Oslo, Norway

    Lars Engebretsen

  18. Aarhus University Hospital, Aarhus, Denmark

    Martin Lind

  19. Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Moises Cohen

  20. Centro de tratamiento de enfermedades articulares, Buenos Aires, Argentina

    Rodrigo Maestu

  21. Fowler Kennedy Sports Medicine Clinic, London, ON, Canada

    Alan Getgood

  22. The Steadman Clinic, Vail, CO, USA

    Robert F. LaPrade

  23. Mayo Clinic, Rochester, MN, USA

    Bruce A. Levy

  24. Cape Town Sports & Orthopaedic Clinic, Cape Town, South Africa

    Richard Von Bormann

  25. International Knee and Joint Centre, Abu Dhabi, UAE

    Charles Brown

  26. Hospital La Fraternidad Habana, Madrid, Spain

    Silvio Villascusa

  27. Parc de Salut Mar, UAB, Barcelona, Spain

    Juan Carlos Monllau

  28. Hospital Clinico Mutual de Seguridad, Santiago, Chile

    Gonzalo Ferrer

  29. University Hospitals of Geneva, Geneva, Switzerland

    Jacques Menetrey

  30. University of Thessalia, Larissa, Greece

    Michael Hantes

  31. Wakamatsu Hospital for the University of Occupational and Environmental Health, Kitakyushu, Japan

    Soshi Uchida

  32. Melbourne Orthopaedic Group, Melbourne, Australia

    Timothy Lording

  33. Nanometer Structure Consortium, Lund University, Lund, Sweden

    Kristian Samuelsson

Authors
  1. Jorge Chahla
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  2. Iain R. Murray
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Corresponding author

Correspondence to Jorge Chahla.

Ethics declarations

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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Chahla, J., Murray, I.R., Robinson, J. et al. Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee Surg Sports Traumatol Arthrosc 27, 2520–2529 (2019). https://doi.org/10.1007/s00167-018-5260-4

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  • DOI: https://doi.org/10.1007/s00167-018-5260-4

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